Ventricular Aneurysm: Diagnosis and Treatment

Ventricular aneurysm—true or pseudo—is a potential complication of transmural myocardial infarction; the establishment of a patent infarct artery reduces the risk of aneurysm formation.^1,2  Ventricular aneurysm may be seen in other conditions such as hypertrophic cardiomyopathy, cardiac sarcoidosis, myocarditis, congenital disease, after cardiac surgery, and in blunt trauma.^3–8 

A true ventricular aneurysm differs from a pseudoaneurysm in terms of morphology and risk of rupture.⁹  A true ventricular aneurysm is thinning of the ventricular wall in an area void of muscle and is caused by fibrosis or scar formation; it is akinetic and bulges during systole and diastole (Figure 1a). A true aneurysm has a wide neck, and the original wall of the myocardium is present within the aneurysmal wall.^1,9 

A pseudoaneurysm has a narrow neck and involves a rupture of the free wall of the left ventricle that...