Unstable Pseudo Disguise A Case of RV Pseudoaneurysm
Document Type
Article
Abstract
Background: Right ventricular pseudoaneurysm (RVP) is a known but rare finding, clinical presentation of which can range from asymptomatic to life-threatening rupture.
Case: A 83-year-old Caucasian male with a history of hypertension, cerebral arterial aneurysm, solitary kidney, diverticulitis presented due to 2 weeks of dyspnea and congestion. He presented with elevated troponin along with type 1 cardiorenal syndrome (CRS) and hyperkalemia, new atrial fibrillation (AFib) with rapid ventricular rate (RVR). Initiated on appropriate therapy with IV heparin and emergent HD which was tolerated. Transthoracic echocardiogram revealed RVP with contained clot, left ventricular hypertrophy, severe aortic stenosis and moderate pulmonary hypertension. Unfortunately suffered asystole due to likely RVP Rupture with ultimate demise.
Decision-making: We started the patient on aggressive medical management for comorbid presentation with the goal of surgical intervention once the patient was stabilized however the patient suffered asystole due to likely RVP Rupture with ultimate demise.
Conclusion: RVP is an extremely rare condition which presents as a delayed complication myocardial infarction, cardiac trauma, catheter injury or cardiac surgery. Since RVP is difficult to suspect based on physical examination, patients with multiple comorbidities and overlapping clinical picture should undergo Echocardiography and catheterization.
First Page
2562
DOI
10.1016/S0735-1097(21)03917-6
Publication Date
5-11-2021
Recommended Citation
Buch T, Patel D, Patel P, Buch A, Rojulpote C, Patel N, Dressel C. UNSTABLE PSEUDO DISGUISE A CASE OF RV PSEUDOANEURYSM. Journal of the American College of Cardiology. 2021 May 11;77(18_Supplement_1):2562-.