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A. Diagram of a false (left) and a true (right) aneurysm. Note a rupture of the left ventricular (LV) wall with the blood contained by the pericardial wall. The
LV does not form the wall of the aneurysm, and the neck of the aneurysm is narrow. The wall of the true aneurysm is formed by the wall of the infarcted
myocardium, and the neck of the aneurysm is wide. B. A true aneurysm is seen at the apex of the heart involving the anteroseptal apical two-thirds of the
LV. The aneurysm is filled with a thrombus, and there is endocardial thickening around the edges of the infarct. C. Healed transmural infarction of the
posteroseptal wall of the LV. Note the thinned and bulging aneurysm of the posterior and septal wall with marked endocardial thickening. No thrombus was
identified within the cavity of the aneurysm. D. A 54-year-old man died suddenly without any significant medical history. At autopsy, there was cardiac
Source: Chapter 57. Pathology of Myocardial Ischemia, Infarction, Reperfusion, and Sudden Death, Hurst's The Heart, 13e
tamponade with ventricular rupture of the posterolateral wall (arrow) secondary to a transmural acute infarction. Ventricular slices of the heart showing the
Fuster
V, Walsh
Harrington
RA.a Hurst's
Heart, 13e;
2011 Available
at: http://mhmedical.com/
Accessed:
May
2017
presence of Citation:
a localized
small
anteriorRA,
aneurysm
from
healedThe
myocardial
infarction
(MI) involving
the anterior and septal
wall of
the09,
LV.
Note the
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organizing thrombus in the aneurysmal cavity. E. False aneurysm. A 47-year-old man presented with sudden-onset shortness of breath and died in the
emergency department. At autopsy, there was a loculated hemopericardium and an LV anteroapical aneurysm secondary to a healed MI with overlying
thrombus. A four-chamber cut of the heart showed extensive adhesions between the visceral and the parietal pericardium, and loculated fresh blood was