Imagiologia cardiovascular de um aneurisma ventricular esquerdo gigante

A 73-year-old man with a history of coronary artery disease and inferoposterior myocardial infarction was referred for cardiology consultation with symptoms of chronic heart failure in NYHA class III. Transthoracic echocardiography revealed a thrombus partially filling a giant pseudoaneurysm/aneurysm of the inferoposterior wall, causing significant deformation of the ventricular geometry (Figure 1; Videos 1--4). Despite the size of the aneurysm, the subvalvular mitral apparatus was intact, with no regurgitation. Given the uncertainty surrounding the differential diagnosis, cardiac magnetic resonance imaging was performed, which confirmed a giant ventricular aneurysm (long axis 6.7 cm) containing a thrombus (Figure 2; Videos 5 and 6), and anticoagulant therapy was