Traumatic False Aneurysm of the Left Ventricle
A 34-year-man was involved in a severe traffic accident 3 years before his current admission and sustained multiple rib and midfacial fractures as well as lung contusion. After 2 months, complete restitution was seen on chest x-ray. Three years later, the patient was scheduled for reconstructive surgery of the midface. Physical examination and laboratory findings at that time were normal. The preoperative chest x-ray, however, demonstrated a large calcified mass adjacent to the anterior wall of the left ventricle (Figure 1). The mass was confirmed by multislice chest CT (Figure 2A) and magnetic resonance imaging (MRI) (Figure 2B through 2D). It was partly filled with floating blood via a small defect of the anterior wall of the left ventricle (arrows in Figure 2A through 2D) while major portions were thrombolized as seen by high signal intensity on black-blood MRI (Figure 2C). Cine MRI (Figure 2D) demonstrated normal thickening of the myocardium, even adjacent to the defect of the myocardial wall. No evidence of coronary artery disease or history of myocardial ischemia was found. Based on these findings, the diagnosis of a traumatic false aneurysm of the anterior left ventricular wall was established.
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
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