Post-infarction left ventricular pseudoaneurysm with septal rupture: a case report.

A patient developed a large left ventricular apical pseudoaneurysm combined with post-infarction ventricular septal rupture following untreated anterior myocardial infarction.

• The patient was a 58-year-old man
• The mechanical complications developed approximately two months after the initial myocardial infarction
• The anterior myocardial infarction was untreated (no reperfusion therapy was administered)
• The ventricular septal rupture extended into the right ventricle, resulting in a significant left-to-right shunt

The patient presented with progressive heart failure as the clinical manifestation of the combined mechanical complications.

• Heart failure developed over a two-month period following the index myocardial infarction
• The presentation occurred in the context of delayed or absent reperfusion therapy
• The combination of pseudoaneurysm and ventricular septal rupture is described as rare and life-threatening

Multimodality imaging was used to diagnose and characterize the structural complications.

• Imaging demonstrated a large left ventricular apical pseudoaneurysm
• Post-infarction ventricular septal rupture into the right ventricle was identified
• The report emphasizes the 'essential role of imaging in diagnosis and surgical planning'
• Multimodality imaging was required to fully characterize the lesions

The patient underwent successful surgical intervention addressing all identified mechanical complications.

• Surgery included aneurysmectomy (resection of the pseudoaneurysm)
• Closure of the ventricular septal defect was performed
• Coronary artery bypass grafting was also carried out
• The surgical outcome is described as successful

The simultaneous occurrence of left ventricular pseudoaneurysm and post-infarction ventricular septal rupture represents a rare combination of mechanical complications.

• The report describes this combination as rare and complex
• The case is presented as contributing 'to the understanding of structural sequelae of myocardial infarction'
• Delayed reperfusion is highlighted as a contributing factor to these mechanical complications
• The case underscores that mechanical complications may still occur despite advances in reperfusion therapy