Incidence, timing and prognostic value of left ventricular aneurysm formation after myocardial infarction: A prospective, serial echocardiographic study of 158 patients

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Abstract

Serial 2-dimensional echocardiography was performed prospectively in 158 consecutive patients with first acute myocardial infarction (AMI) to determine the incidence of left ventricular (LV) aneurysm formation and the time course required for, and the clinical significance of, onset of LV aneurysm formation. Studies were performed throughout the first 5 days and after 3 months and 1 year. LV aneurysm was defined as an abnormal bulge in the LV contour during both systole and diastole. Eighty-four patients had anterior, 68 posterior and 6 anteroposterior AMI defined echocardiographically. During the study period, LV aneurysm was found in 35 of 158 patients (22%); in anterior AMI in 27, in posterior AMI in 6 and in anteroposterior AMI in 2. No new aneurysm developed after 3 months. Early aneurysm formation, during the first 5 days after AMI, was seen in 15 patients with anterior infarction. Twelve of these 15 (80%) died within 1 year (10 within 3 months), in contrast to 5 (25%) of the remaining 20 patients with LV aneurysm (p < 0.05). Dyskinesia of the anterior wall in the acute stage usually resulted in aneurysm formation. Thus, LV aneurysm formation is seen in 22% of mostly anterior AMI and occurs within 3 months after AMI. Early aneurysm formation is associated with a high 3 month (67%) and 1-year (80%) mortality rate.

References (29)

  • DL Abrams et al.

    Ventricular aneurysm: a reappraisal based on a study of 65 consecutive autopsied cases

    Circulation

    (1963)
  • JB Johnson et al.

    Ventricular aneurysm after infarction: pathological and surgical features

    J Thorac Cardiovasc Surg

    (1969)
  • J Schlichter et al.

    Aneurysm of the heart: a correlative study of 102 proved cases

    Medicine

    (1954)
  • HS Cabin et al.

    Left ventricular aneurysm, intraaneurysmal thrombus and systemic embolus in coronary heart disease

    Chest

    (1982)
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