Presentation
History of prior myocardial infarction, now with shortness of breath.
Patient Data
Severe thinning of the left ventricular apical myocardium, adjacent septum and lateral wall due to prior myocardial infarction. Presence of LAD stent and atherosclerotic calcification. Associated post-infarction ventricular septal defect involving the apical aspect of the septum is noted. There is no intraventricular thrombus.
Intra-aortic balloon pump is appropriately positioned.
Note left pleural effusion with adjacent collapsed consolidation.
Intra-aortic balloon pump with its tip in the mid aspect of the aortic knob. Left PICC line with its tip within the SVC. Minimal pulmonary edema pattern is noted.
Case Discussion
This patient developed 2 complications related to a prior left anterior descending artery myocardial infarction: 1) a true aneurysm involving the cardiac apex and 2) a ventricular septal defect. Both of these structures are perfused by the LAD.
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