Circulation. 2007;115:e376-e377
doi: 10.1161/CIRCULATIONAHA.106.656694
(Circulation. 2007;115:e376-e377.)
© 2007 American Heart Association, Inc.
Images in Cardiovascular Medicine |
A Ring in the Heart Calcified Left Ventricular Aneurysm
Carlos Harrison-Gómez, MD;
Ashley Harrison-Ragle, BA;
Adalberto Arceo-Navarro, MD
From The Faculty of Medicine of León, University of Guanajuato, León, México (C.H.-G., A.H.-R.), and Cardiology Department, Hospital Angeles Léon, León, México (C.H.-G., A.A.-N.).
Correspondence to Dr Carlos Harrison-Gómez (Cardiología), Facultad de Medicina de Léon, Universidad de Guanajuato, 20 de Enero 929, Col. Obregón, León, Gto. México. CP 37320. E-mail charrison{at}prodigy.net.mx
A 75-year-old man had a smoking habit of 60 cigarettes per day. Eighteen years ago, he had an anterior wall myocardial infarction. Seven years ago, he had a stroke with left hemiparesia that improved completely in the next few weeks. After that, he remained in functional class II, and he did not complain of dyspnea or angina.
One year ago, the patient was admitted to the hospital because of mild dyspnea. He did not have dizziness or sincopal episodes. A complete atrioventricular block was diagnosed with a ventricular rate of 33 bpm. The fluoroscopic image during pacemaker implantation revealed a calcified ring in different projections, related to an anteroapical calcified aneurysm. He was discharged and continued asymptomatic, walking 3 km in 50 to 60 minutes 3 times a week. Recently, he presented because of transient cerebral ischemic attacks. A chest x-ray showed a peculiar oval calcified image related to a left ventricle aneurysm (Figures 1 and 2
). On the basis of a previously published noncontrasted computed tomography scan of a patient with a calcified left ventricular aneurysm which did not confirm a possible partly calcified apical thrombus,1–2 we performed a contrasted computed tomography scan, which showed the calcified aneurysm and a mural apical thrombus with calcifications that suggested an old thrombus (Figure 3).
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Figure 1. Thorax x-ray showing the pacemaker, an enlarged heart, and an oval-shaped calcified structure related to a calcified anteroapical left ventricular aneurysm.
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Figure 3. Computed tomography showing an enlarged left ventricle and calcified anteroapical aneurysm. The mural thrombus with dense, calcified spots in its interior indicates an old thrombus.
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Disclosures
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None.
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References
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- Lee BK, Atwood JE. Calcified left ventricular aneurysm. N Engl J Med. 2003; 348: 918.[Free Full Text]
- Achenbach S, Popers D. Calcified left ventricular aneurysm. N Engl J Med. 2003; 348: 2469.[Free Full Text]
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Disclosures
References