Özet:

A 51-year-old man was referred to our institution for dyspnea on exertion and non-productive cough, of three-month history. His clinical history was characterized by a silent inferior myocardial infarction detected by an ECG that presented inferior Q waves. He had not previously presented symptoms. Two-dimensional transthoracic echocardiography demonstrated a second large cardiac chamber (6 x 5 cm) adjacent to the inferior-basal left ventricle wall, with a narrow neck and to-and-from signals at doppler evaluation. Ventriculography showed a pseudoaneurysm, like an hourglass, on the inferior wall of the left ventricle which is approximately 6 x 5 cm in diameters. Coronary angiography showed triple vessel disease with total occlusion of the circumflex coronary artery. These findings were consistent with left ventricular pseudoaneurysm resulting from an old inferior myocardial infarction. After diagnosis of left ventricular pseudoaneurysm and concomitant coronary artery disease, surgery was recommended. He underwent coronary artery bypass surgery including the repair of the pseudoaneurysm. But, unfortunately the patient died in during the operation. This case illustrates that pseudoaneurysm could develop after silent myocardial infarction with non-specific symptoms. In addition, if false aneurysm invades adjacent organs such as lungs, increases the risk of surgical mortality.

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