Left ventricular outflow tract pseudoaneurysm diagnosed with point-of-care ultrasound in the emergency department

Abstract

Left ventricular outflow tract pseudoaneurysms are a rare but life-threatening disorder, often caused by complications of cardiac surgery or myocardial infarction. We present a case report of a patient with no prior risk factors who presented with a six-month history of progressive exertional dyspnea, bilateral leg swelling and cough. Point-of-care ultrasound revealed an unexpected outpouching of the left ventricle. He was diagnosed with a left ventricular outflow tract pseudoaneurysm and subsequently went into cardiogenic shock secondary to extension of pseudoaneurysm causing extrinsic compression of the coronary arteries. The patient underwent successful emergency surgical repair and made a full recovery.

Giant left ventricular outflow tract pseudoaneurysm presenting as anterior mediastinal mass: diagnosis by MDCT

“…They can also present with symptoms due to compression of adjacent vital structures. Most of these cases can be diagnosed using transthoracic and transesophageal echocardiography [5]; however, echocardiography cannot give accurate three-dimensional images for preoperative planning. In our case, although transthoracic echocardiography confirmed the presence of aneurysm, the exact site, size, shape, its relationship with aortic root, coronary artery status, presence of complications like thrombus, rupture, fistula, compression of adjacent structures, and associated lung findings were exactly delineated by MDCT cardiac angiography [6,7].…”