Fact-sheet: Ventricular aneurysm
Updated on 01/15/2016 at 10:42 AM
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Definition
- corresponds to a loss of the normal contour of the LV in diastole
- most often secondary to myocardial infarction
- occurs in 5 to 10% of MI cases
- wall composed of scarred myocardial tissue resulting from transmural necrosis, without viable and functional muscle
- Location: most often at the apex but any ventricular wall may be involved
- Complication: intracavitary thrombus, ventricular tachycardia, left ventricular failure, rupture
MRI
- Aneurysmal dilation of the left ventricular cavity on all sequences, wall thinned compared to adjacent myocardium - Junction of the aneurysmal wall with healthy myocardium is gradual with a gentle slope, and the neck is wide +++ (unlike pseudoaneurysm, the main differential diagnosis) - Cine sequence: akinetic or dyskinetic pattern (no contraction or thickening during systole, or even bulging) - Viability sequence 10 min after gadolinium injection: characteristic transmural wall enhancement (fibrous scar tissue)
Differential diagnosis
Pseudoaneurysm:
- also corresponds to a loss of the normal LV contour in diastole BUT the wall is composed solely of epicardium and pericardium (risk of secondary rupture is much more frequent)
- acute angles at the junction with adjacent myocardium and a narrow neck
Congenital diverticula