A Silent Dissection Complicating Myocardial Infarction: A Case Report

A Silent Dissection Complicating Myocardial Infarction: A Case Report

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A Left Ventricular (LV) pseudoaneurysm develops when free myocardial wall rupture is contained by an adherent layer of overlying pericardium and scar tissue.It is a rare mechanical complication seen in 0.2% of patients post Myocardial Infarction (MI).Furthermore, it remains a challenge to diagnose and alpha industries green 59fifty fitted differentiate it from a true aneurysm due to overlapping clinical presentations and echocardiographic findings.

A 40-year-old male patient presented with ST Elevation Myocardial Infarction (STEMI) and received guideline directed management.However, he was later found to have a pansystolic murmur at the apex and an early diastolic murmur over the left lower sternal border (to and fro murmur) on auscultation.An echocardiogram had subsequently revealed a dissecting pseudoaneurysm of the left ventricle and Contrast-enhanced Computed Tomography (CECT) confirmed the presence of an anterior dissecting pseudoaneurysm.This is an atypical presentation of a replica grease gun niche post MI complication due to its asymptomatic presentation, atypical location and unique anatomy despite prompt revascularisation.

Furthermore, the authors emphasise the importance of cardiac auscultation on a day-to-day basis and high index of suspicion to ensure early diagnosis and management of such a silent, calamitous complication.