Postinfarction ventricular aneurysm

DUBNOW, MORTON H.; Burchell, Howard B.; Titus, Jack L.

doi:10.1016/0002-8703(65)90331-5

Cited by 275 publications

(21 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Figures, however, differ widely in different series depending on the criteria accepted for the diagnosis of ventricular aneurysm. Thus, Dubnow et al (1965) used the criteria of Edwards (1961), of a protrusion of a localized portion of the external aspect of the ventricle accompanied by a corresponding protrusion of the ventricular cavity: their reported incidence of ventricular aneurysm was only 3-5 per cent which, as might be expected, corresponded fairly closely with the incidence of major ventricular aneurysm in our series (3%). Gorlin et al (1967), on the other hand, using cineradiological criteria for diagnosis, found evidence of aneurysm in as many as 24 out of 100 cases of ischaemic heart disease.…”

Section: Discussionsupporting

confidence: 82%

See 1 more Smart Citation

Clinical diagnosis and prognosis of ventricular aneurysm.

Mourdjinis¹,

Olsen²,

Raphaël³

et al. 1968

Heart

View full text Add to dashboard Cite

Where a full thickness infarct has occurred with replacement of myocardium by fibrous tissue, this inert portion of the ventricular wall cannot take part in concentric contraction and herniates outwards during ventricular systole. This localized disturbance of ventricular contraction after acute myocardial infarction is seen not only in large ventricular aneurysms but alsowith smaller full thickness infarcts (minor aneurysms) that have not caused a definite protrusion of the external surface of the heart. In this paper the range of localized disorders of ventricular contraction has been studied clinically, radiologically, at operation, and at necropsy. In diagnosis, special emphasis has been placed on abnormalities of the cardiac impulse, readily appreciated at the bedside, and on the information obtained from detailed fluoroscopy.The prognosis after acute myocardial infarction depends not only on the possibility of a further infarct occurring, but also on the degree of damage that the infarct has inflicted on the ventricles as an efficient pump. The influence of major and minor aneurysms on prognosis following myocardial infarction has been examined. SUBJECTS AND METHODSThe 39 patients studied fell into 2 main groups.There were 13 patients in whom the diagnosis of ventricular aneurysm was confirmed either at operation or at necropsy. The second group consisted of 26 patients in whom the diagnosis of ventricular aneurysm was made on clinical and radiological grounds alone. Of these 39 patients, 18 were diagnosed as having a ventricular aneurysm during admission to Hammersmith Hospital in a series of 112 consecutive patients treated in the Acute Coronary Care Unit

show abstract

Section: Discussionsupporting

confidence: 82%

“…in diameter. The site of the aneurysm was most frequently anterior, extending down to the apex, as reported by Parkinson, Bedford, and Thomson (1938), Dubnow, Burchell, and Titus (1965), and Gorlin et al (1967). In only 7 of our 39 patients was the aneurysm postero-inferior in position.…”

Section: Discussionmentioning

confidence: 56%

Clinical diagnosis and prognosis of ventricular aneurysm.

Mourdjinis¹,

Olsen²,

Raphaël³

et al. 1968

Heart

View full text Add to dashboard Cite

show abstract

“…McAfee and Thakur2`2 6 were the first to label cells with indium. Subsequent studies in animals demonstrated the potential of indium-labeled platelets in the diagnosis of infective endocarditis,27 myocardial inTAiiit, 4 We had some problems with interpreting platelet images.…”

Section: Discussionmentioning

confidence: 99%

“…"3 In recent years the primary role of coronary thrombus in precipitating AMI has been questioned. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] To evaluate the significance of coronary thrombus in AMI, we examined in detail the coronary arteries containing thrombi in 54 necropsy patients with transmural AMI. Several previously undescribed observations on coronary thrombi resulted, which clarify the significance of coronary thrombi in AMI.…”

Section: Discussionmentioning

confidence: 99%

Identification of left ventricular thrombi in man using indium-111-labeled autologous platelets. A preliminary report.

Ezekowitz¹,

Leonard²,

Smith³

et al. 1981

Circulation

View full text Add to dashboard Cite

SUMMARY Indium-111 ("'In) bound to 8-hydroxyquinoline can be used to label platelets without impairing their ability to participate in active thrombosis. The purpose of this study was to identify intracardiac thrombi using "'In platelet scintigraphy. Twenty-nine patients were studied. Twenty-one had discrete left ventricular aneurysms (group 1). The remaining eight patients (group 2) had normal or minimally narrowed coronary vessels (< 50%) and a global ejection fraction of 54 ± 14% (mean i SD) without segmental dysfunction on contrast ventriculography. Six of the eight patients with insignificant coronary disease had severe mitral valve disease requiring surgery. Each intravenous injection contained 3.4 ± 1.6 X 109 platelets labeled in a solution of acid citrate dextrose and saline (1:7, pH 6.5) with 454 ± 144 ,Ci (mean ± SD) "'In complexed to 8-hydroxyquinoline with a final labeling efficiency of 67 ± 17%. Platelet recovery at 15 minutes was 37.8 + 14.5% (mean i SD; n = 15). Imaging was performed in the anterior, left anterior oblique 450 and left lateral views (the right anterior oblique 450 view was included in all except patients 1-5 in group 1) on the day of injection and at 1-2-day intervals for a maximum of 8 days. In group 1, nine patients had abnormal areas of increased activity within the left ventricle. Four required aneurysmectomy and had left ventricular thrombi; a fifth died and at autopsy evidence of a thrombus was found. In four patients (the only patients in whom these data were obtained), surface thrombus "'In activity was at least 9.7 times greater than that of blood, noninvolved myocardium and deeper aspects of the thrombus. Twelve patients with aneurysms had normal scintiphotos. Six required aneurysmectomy and were negative for thrombi. All the patients in group 2 had negative platelet scintiphotos. The six patients who required mitral valve replacement had no thrombi at surgery. Therefore, the diagnostic accuracy of platelet scintigraphy (both groups) in the 17 patients in whom surgical or postmortem confirmation of thrombi could be obtained, five of whom had positive scintiphotos, was 100%. We conclude from this preliminary study that "1'In platelet scintigraphy promises to be a reliable method for the identification of left ventricular thrombi.INDIUM-111 ("'In) is a gamma-emitting radionuclide that emits two photons per disintegration with energies of 173 and 247 KeV and has a half-life of 67 hours. It is well suited for scintigraphic imaging. When bound to 8-hydroxyquinoline, it forms a lipidsoluble compound that is an effective platelet label and does not appear to affect the ability of the cell to participate in thrombus formation.' Therefore, platelets labeled in this way seem suitable for the detection of hematologically active intracardiac thrombi.Thirty to 70 percent5"8 of patients with left ventricular aneurysms, proved at autopsy or surgery, have mural thrombi. In clinical studies, systemic emboli occur in 6-13%5 9, 10 of patients with aneurysms, and the incidence is even higher...

show abstract

“…For ex ample, the presence of left ventricular aneurysm carries an increased risk of death which is independent of global left ventricular function [1] and is associated with a higher incidence of thrombus formation with subsequent peripheral embolization [2][3][4], The 12-lead electrocar diogram may be useful in recognizing some of these indi viduals. For instance, persistent S-T segment elevation following acute myocardial infarction has been suggested to be a marker for left ventricular aneurysm [5][6][7], While some investigators have reported a good correlation [5-Methods persistent S-T segment elevation and wall mo tion abnormality: aneurysm, dyskinesis or akinesis by radionuclide ventriculography persistent S-T segment elevation and no wall motion abnormality: aneurysm, dyskinesis or akinesis by radionuclide ventriculography no persistent S-T segment elevation and no wall motion abnormality: aneurysm, dyskinesis or akinesis by radionuclide ventriculography no persistent S-T segment elevation and wall motion abnormality: aneurysm, dyskinesis or akinesis by radionuclide ventriculography True-positives Patient Selection. Data from 438 consecutive patients who had both a radionuclide ventriculogram and a 12-lead electrocardiogram obtained within 2 weeks of each other were reviewed.…”

Section: Introductionmentioning

confidence: 99%

Relationship of Persistent S-T Segment Elevation and Left Ventricular Wall Motion Abnormalities

Sadaniantz¹,

Hedmann²,

Carleton³

et al. 1989

Am J Noninvas Cardiol

View full text Add to dashboard Cite

Persistent precordial S-T segment elevation has been assumed to be evidence of left ventricular aneurysm. To evaluate this hypothesis, we examined the electrocardiograms and radionuclide ventriculograms of 374 consecutive patients referred to the nuclear cardiology laboratory for evaluation of ventricular function. Patients with major intraventricular conduction abnormalities, left and right bundle branch block, pacemaker-dependent rhythms and inferior wall aneurysms were excluded. Among 40 patients with persistent S-T segment elevation, 29 (73%) had left ventricular aneurysm, whereas aneurysm was present in only 21 (6%) of 334 patients without S-T segment elevation. There were 70 patients with Q wave anterior myocardial infarction. Among those patients with S-T segment elevation, 74% had left ventricular aneurysm, 47% had dyskinetic wall motion and 94% had akinetic wall motion. Among those patients without S-T segment elevation, 25% had left ventricular aneurysm, 8% had dyskinesis and 58% had akinesis. We conclude that the presence of persistent S-T segment elevation on the electrocardiogram is predictive of severe forms of wall motion abnormalities of the left ventricle including aneurysm.

show abstract

Postinfarction ventricular aneurysm

Cited by 275 publications

References 34 publications

Clinical diagnosis and prognosis of ventricular aneurysm.

Clinical diagnosis and prognosis of ventricular aneurysm.

Identification of left ventricular thrombi in man using indium-111-labeled autologous platelets. A preliminary report.

Relationship of Persistent S-T Segment Elevation and Left Ventricular Wall Motion Abnormalities

Contact Info

Product

Resources

About