Role of multimodality imaging in a patient with posterior left ventricular aneurysm and non-compaction: Review of the li
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n, Guanajuato, Mexico Department of Medicine, Universidad de Guanajuato. Leo ´n, Mexico Department of Cardiology, Hospital de Alta Especialidad ISSSTE, Morelia, Michoaca ´ dica Campestre, Leo ´ n, Guanajuato, Mexico Department of Radiology, Hospital Me ´n, Department of Cardiac Surgery, Hospital de Alta Especialidad ISSSTE, Morelia, Michoaca Mexico ´ n, Guanajuato, Mexico Department of Electrophysiology, Hospital Aranda de La Parra, Leo ´ n, Cardiac Unit of Intensive Care, Hospital Regional de Alta Especialidad del Bajı´o, Leo Guanajuato, Mexico Department of Cardiovascular Research, Lankenau Institute for Medical Research, Wynnewood, PA Department of Nuclear Cardiology and Cardiac CT, Hospital Siena del Moral, Cardimax ´ n, Guanajuato Research Center, Leo , Mexico
Received Aug 30, 2020; accepted Aug 31, 2020 doi:10.1007/s12350-020-02365-0
CASE PRESENTATION The patient is a 59-year-old man, (height: 50 4, weight: 143 lbs), who has been moderately active throughout his life and had no known coronary risk factors and was asymptomatic until 4 months ago, when suddenly he started having chest pains. He did not seek medical advice till 10 days later at which time he started having increasing shortness of breath and swelling of the legs. He was seen in outside clinic and was started on aspirin and low doses of a diuretic and a betablocker. His symptoms progressed and he was referred to our medical center.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12350-020-02365-0) contains supplementary material, which is available to authorized users. Reprint requests: Andre´s Preciado-Anaya, MD, Department of Nuclear Cardiology and Cardiac CT, Hospital Siena del Moral, Cardimax Research Center, 37160 Leo´n, Guanajuato , Mexico; [email protected] J Nucl Cardiol 1071-3581/$34.00 Copyright Ó 2020 American Society of Nuclear Cardiology.
His blood pressure was 100/70 mmHg the heart rate of 60 bpm and the oxygen saturation was 93% on room air. The electrocardiogram showed sinus rhythm with QS pattern in II, III, aVF and V6, without ST-segment elevation (Figure 1). A 2-dimensional echocardiogram showed inferolateral left ventricular (LV) aneurysm and mild mitral regurgitation (Figure 2). The left ventricular ejection fraction (EF) was 42%. Rest/stress (vasodilator) gated SPECT myocardial perfusion imaging using Tc-99m labeled tracer was performed, which showed a severe and large fixed perfusion defect in the inferior and lateral walls of the LV (Figure 3). A repeat study with Thallium-201 (rest/ redistribution) showed a similar perfusion pattern (Figure 4). A multislice cardiac tomography (MSCT) showed inferolateral LV aneurysm (Figure 5). The aneurysm measured at diastole 40.9 mm 9 56.4 mm in the axial view; 53.9 mm 9 25.1 mm in the sagittal view and 49.6 mm 9 28.8 mm in the mid ventricularshort axis view. The maximum diameter from the aneurysm to the LV septal wall was 92.6 mm. No
Preciado-Gutie´rrez et al Role of multimodality imaging in a patient
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