A Case of Tuberculous Pericarditis Associated with Pseudoaneurysm of the Left Ventricle

Nam Jin Yoo; Jong Cheol Park; Kyeong A Oh; Kyeong Nyeon Kim; Jin Won Jeong; Yang Kyu Park; Ock Kyu Park

doi:10.3803/jkes.1994.2.1.104

Journal List > J Korean Soc Echocardiogr > v.2(1) > 1075159

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Yoo, Park, Oh, Kim, Jeong, Park, and Park: A Case of Tuberculous Pericarditis Associated with Pseudoaneurysm of the Left Ventricle

Original Article

J Korean Soc Echocardiogr 1994;2(1):104-108.

Published online: 18 February 1994

DOI: https://doi.org/10.3803/jkes.1994.2.1.104

A Case of Tuberculous Pericarditis Associated with Pseudoaneurysm of the Left Ventricle

Nam Jin Yoo, M.D., Jong Cheol Park, M.D., Kyeong A Oh, M.D., Kyeong Nyeon Kim, M.D., Jin Won Jeong, M.D., Yang Kyu Park, M.D., Ock Kyu Park, M.D.

Department of Internal Medicine, Wonkwong University School of Medicine, Iri, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The incidence of left ventricular pseudoaneurysm is not known, but it appears to be quite rare^1–11). We experienced a case of apical pseudoaneurysm of left ventricle in a 73-year-old female who presented with progressive orthopnea. On the 2nd hospital day, cardiac tamponade developed. A small pseudoaneurysm of left ventricle with narrow neck associated with massive pericardial effusion was demonstrated by transthoracic echocardiography.

Emergency coronary angiogram showed normal. Emergency operation was performed on the suspicion of rupture of the pseudoaneurysm. Microscopic examination of the wall of the aneurysm revealed fibrous tissue adhered to the granulomatous inflammatory pericardium.

Keywords: Pseudoaneurysm, Tuberculous Pericarditis, Cardiac tamponade.

References

1). Sabiston DC. Surgery of the chest. 5th ed.p. 1766. Philadelphia: W.B. Saunders Com;1990.

2). Abrams DL. Ventricular aneurysm. Circulation. 27:164. 1963.

3). Stewart S. False aneurysm and pseudo-false aneurysm of the left ventricle: Etiology, pathology, diagnosis, and operative management. Ann Thorac Surg. 31:259. 1981.

4). Van Tassel A. Rupture of the heart complicating myocardial infarction: Analysis of 40 cases including nine examples of left ventricular false aneurysm. Chest. 61:104. 1972.

5). Human DG. Tuberculous aneurysm of the left ventricle: A case report. South African Med J. 64:26. 1983.

6). Salsena FB. Infective aneurysm of the left ventricle: Angio-graphic and echocardiographic features. Am Heart J. 96:385. 1978.

7). Gray M, Thaker NS. Congenital calcified, apical aneurysm of the left ventricle in an adult. Eur Heart J. 8:72. 1987.

8). Chesler E. Subventricular and apical left ventricular aneurysms in the Bantu as a source of systemic unborn. Circulation. 35:1156. 1967.

9). Arora RR, Issenberg HJ. Congenital aneurysm of the ventricle: Its recognition and significance. JAMA. 259:3306. 1988.

10). Spindola-Franco H. Aneurysm of the heart: A correlative study of 102 proved cases. Medicine. 33:43. 1954.

11). Spindola-Franco H. Pseudoaneurysm of the left ventricle. Radiology. 127:23. 1978.

12). Escarous A. CT findings of a posterior false aneurysm of the left ventricleAm J Rad. 152:1339. 1989.

13). Roelandt J, Brand M. Echocardiographic diagnosis of pseudo-aneurysm of the left ventricle. Circulation. 52:466. 1975.

14). Glover MU, Hagan AD. Pseudoaneurysm of the left ventricule diagnosed by two-dimensional echocardiography: Case report. Military Med. 146:696. 1981.

15). Grondin P, Kretz JG. Natural history of saccular aneurysms of the left ventricle. J Thor Card Surg. 77:57. 1979.

16). Vlodaver Z. True and false left ventricular aneurysm. Circulation. 51:567. 1975.

Fig. 1.

Chest PA roentgenogram shows marked cardiomegaly with well defined silhouette and blunting of both costophrenic angle with thickening of right major fissure.

Fig. 2.

Standard electrocardiogram shows sinus tachycardia with Q wave in lead II, III, aVF and diffuse non-specific ST-T change.

Fig. 3.

Subcostal(A) and apical four-chamber view(B) of two-dimensional and Doppler echocardiogram show massive pericardial effusion and apical left ventricular pseudoaneurysm with narrow neck, which communicate with left ventricular cavity(P.E: pericardial effusion, RV: right ventricle, LV: left ventricle).

Fig. 4.

Microscopic examination of the pericardium revealed granuloma with Langerhans'cell and infiltraion of inflammatory cells(H & E)(A: 100, B: 200).

TOOLS

Similar articles