J Korean Soc Echocardiogr.  1994 Jul;2(1):104-108. 10.4250/jkse.1994.2.1.104.

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

• Yoo NJ
• Park JC
• Oh KA
• Kim KN
• Jeong JW
• Park YK
• Park OK

• KMID: 2410466
• DOI: http://doi.org/10.4250/jkse.1994.2.1.104

Abstract

The incidence of left ventricular pseudoaneurysm is not known, but it appears to be quite rare. 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.

Keyword

Pseudoaneurysm; Tuberculous Pericarditis; Cardiac tamponade

MeSH Terms

Aged
Aneurysm
Aneurysm, False*
Cardiac Tamponade
Echocardiography
Emergencies
Female
Heart Ventricles*
Humans
Incidence
Neck
Pericardial Effusion
Pericarditis, Tuberculous*
Pericardium
Rupture

Figure

• 

  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).

Reference

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