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- echocardiography
- acute coronary syndrome
- heart failure
- myocardial infarction
- mechanical complication
- pseudoaneurysm
Clinical introduction
A man in his 50s presented with progressive worsening of dyspnoea after a recent inferior wall myocardial infarction. His vitals were stable and examination revealed a pansystolic murmur at the apex. The patient had undergone a coronary angiography prior to referral which showed complete obstruction of the distal left circumflex artery.
Question
The transthoracic echocardiogram is shown in figure 1 and video 1.
Transthoracic echocardiography. (A) Parasternal long axis view, (B) parasternal short axis view.
What is the diagnosis?
Left ventricular pseudoaneurysm
True aneurysm
Ventricular septal rupture
Free wall rupture
Answer: A
The echocardiogram shows a small defect in the inferior wall of the left ventricle (LV) communicating with a sac-like structure. Colour Doppler across the defect shows …
Footnotes
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Contributors All authors contributed to design, draft preparation and review of the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; internally peer reviewed.