Abstract| Volume 23, ISSUE 10, SUPPLEMENT , S51, October 2017

A Case of Subepicardial Aneurysm That Was Diagnosed by Echocardiography in the Emergency Room and Underwent Successful Surgery

      A 91-year-old woman was admitted because of chest pain for 12 hours. Electrocardiography showed ST-segment elevation on leads II, III, aVF. We therefore suspected an inferior wall acute myocardial infarction. Transthoracic echocardiographic examination was performed in the emergency room, which demonstrated that the inferior segment of the left ventricular walls was akinetic with normal thickness in the 2-chamber view, but the dissected myocardium and the aneurysmal pouch was observed in the area of inferior segment. A small amount of pericardial effusion and diastolic right ventricular collapse were detected. A subepicardial aneurysm with impending rupture was diagnosed and the emergent surgical repair was prepared. Coronary angiography before operation revealed total occlusion of the posterior descending artery of the right coronary artery; the left anterior descending and circumflex arteries showed no abnormalities. The surgical repair of subepicardial aneurysm was successfully performed and the patient was discharged 30 days after operation without any complications. Echocardiographic examination in the emergency room was useful to detect the subepicardial aneurysm after myocardial infarction and to decide the therapeutic strategy.
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