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inferior ischemic pseudoaneurysm with VSD

added by Emmel

inferior ischemic pseudoaneurysm with VSD
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Posted By: magehana47 (1292 days ago)

nice cases


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Emmel

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Added: 21-01-2014
Runtime: 0m 26s
Views: 41020
Comments: 1

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Description

about 60 y old patient without typical clinical afflictions of myocardial ischemia (Diabetes type 2 is known: silent ischemia? or only indolent aptient?). The patient was admitted to our ER with weakness and diarrhoea. In ECG we found a sign of myocardial infarction stadium I-II in inferior leads, no signs of disturbance in V1-V6. Also we heard a new heard murmur (holosystolic murmur in Erb-point). Blood-sample showed us distinct elevated liver enzymes (GOT > 1000 U/l, GPT > 800 U/L) and severe disturbance of electrolytes (Na 115 mmol/l, K 5,8 mmol/l); lactate was elevated with 4,8 mmol/l with respiratory compensation. In TTE I found a inferior (pseudo-)aneurysm with perforation (VSD) in right ventricle (inferior-septale) with acute leading pressure and secundary volume overload of right ventricle. Overall signs of acute RV-failure (maybe a myocardial infarction of right ventricle too). Definitely NO clinical afflictions; NO haemodynamic instability.


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