What is Ventricular Aneurysm?

Ventricular aneurysm is signed by a balloon like in left ventricle (much more common in left ventricle) that make ventricle disfunction after myocardium infarction. Ventricular aneurysm will be developed soon after myocardium infarction (for days or years). Untreat ventricular aneurysm will develop to arrythmia, systemic emboli, heart failure, and sudden death. Ressection increases prognosis result for patient that has heart failure or refractory ventriculer arrythmia.

Etiology

Myocardia infaction that damage ventricle muscle especially left ventricle. Nekrosis process will make ventricle wall thin. Then it will become widen caused by intracardiac pressure to make sacus non contractile (aneurysm).

Sign and Symptoms

  • Arrythima like premature vintricle contraction and ventricle tachycaria
  • Congestive heart failure signed by dyspnea, weakness, edema, jugulary vein distention
  • Left ventricle disfunction
  • Palpitation
  • Pulmonary edema
  • Pulsus alternans with left side heart failure
  • Sign and symptoms of cardiac dysfunction like weakness, fatigue, and angina
  • Systemic emboli
  • Precordial bump that is palpable

Diagnostic examination

  1. Venriculography to know ventricle enlargement with akinesia or dyskinesia (during sineangiography) and cardiac function decrease
  2. Electrocardiography shows persistent ST-T elevation after myocardium infarction
  3. X-ray shows abnormal bump that changes heart contour if the aneurysm form is large, x-ray will show normal result if the aneurysm in small size
  4. Non-invasive nuclear cardiology scan indicates infarction places and aneurysm area
  5. Echocardiography shows abnormal movement of left ventricle.

Treatment

  1. Treatment for ventricular aneurysm only needs routine diagnosis examination to folow the patient’s condition or agressive method to handle arrythmia , heart failure, and emboli
  2. Antiarrythmia intravenously with oral medication like procaniamide, quinidine, or disopyramide.
  3. Cardioversion
  4. First aid when there is heart failure with pulmonary edema by oxygenation, digoxin, furosemide, morphine sulfate, nitroprusside, and intubation if needed. Maintenance therapy like oral nitrate and angiotensin enzyme inhibitor like captopril or enalapril
  5. Systemic emboli needs anticoagulant or embolectomy
  6. Refractory ventricular tachycardia, heart failure, recurrent arterial embolism, and persistent angina with artery occlusion need surgery (aneurysmectomy with myocardium revascularization)

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