Postmyocardial Infarction Ventricular Aneurysm: JACC Focus Seminar 5/5

Roberto Lorusso, Matteo Matteucci, Stamatios Lerakis, Daniele Ronco, Lorenzo Menicanti, Samin K. Sharma, Pedro R. Moreno

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

Ventricular aneurysm represents a rare complication of transmural acute myocardial infarction, although other cardiac, congenital, or metabolic diseases may also predispose to such condition. Ventricular expansion includes all the cardiac layers, usually with a large segment involved. Adverse events include recurrent angina, reduced ventricular stroke volume with congestive heart failure, mitral regurgitation, thromboembolism, and ventricular arrhythmias. Multimodality imaging is paramount to provide comprehensive assessment, allowing for appropriate therapeutic decision-making. When indicated, surgical intervention remains the gold standard, although additional therapy (heart failure, anticoagulation, and advanced antiarrhythmic treatment) might be required. However, the STICH (Surgical Treatment for Ischemic Heart Failure) trial did not show any advantage from adding surgical ventricular reconstruction to coronary artery bypass surgery in terms of survival, rehospitalization or symptoms, compared with revascularization alone. Finally, implantable cardiac defibrillator may reduce the risk of fatal arrhythmias.

Original languageEnglish
Pages (from-to)1917-1935
Number of pages19
JournalJournal of the American College of Cardiology
Volume83
Issue number19
DOIs
StatePublished - 14 May 2024

Keywords

  • acute myocardial infarction
  • congestive heart failure
  • post-myocardial infarction complication
  • surgical ventricular reconstruction
  • ventricular aneurysm
  • ventricular arrhythmias

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