N.V. Zatoloka, A.A. Popova, E.G. Komarovskaya
Aneurysm of the left ventricle is a well-defined area of a thin scar deprived of the muscle layer that develops after myocardial infarction with systolic akinesia or dyskinesia, which impairs its normal geometry and contractility and, as a result, reduces the ejection fraction. There are two strategies for treating left ventricular aneurysm, i.e. medication and surgery. Surgical treatment is absolutely indicated for patients with dyskinetic (akinetic) aneurysms with an increase in the endsystolic index > 80 ml/m 2 and in the end-diastolic index > 120 ml/m 2 , as well as with the threat of rupture or the development of a false aneurysm. A clinical case of a 72-year-old patient is presented. After myocardial infarction there developed a giant aneurysm of the left ventricle filled with a large thrombus. Due to the ineffectiveness of conservative treatment and the impossibility of surgical remodeling of the left ventricle using standard methods, the patient will have to undergo an orthotopic heart transplantation. This case is of interest due to the rare occurrence of such a clinical scenario of this pathology.
keywords: aneurysm, left ventricular aneurysm, echocardiography, dyspnea
for references: N.V. Zatoloka, A.A. Popova, E.G. Komarovskaya. Giant left ventricular aneurysm: sonographer’s view. Neotlozhnaya kardiologiya i kardiovaskulyarnye riski [Emergency cardiology and cardiovascular risks], 2020, vol. 4, no. 1, pp. 886–888
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