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After several patients in this series developed subarachnoid hemorrhage from a ruptured mycotic aneurysm, we proceeded to institute weekly cerebral angiography protocol. This detected moderate to severe vasospasm in 75%, and aneurysms in 58%, with the most common site being the basilar artery.
Of the 32 patients, 9(28.1%) had dissection with diagnostic angiograms, 6(18.8%) endovascular thrombectomy, 15(46.9%) aneurysm treatment, and 2(6.3%) angioplasty with or without stenting. Common comorbidities included hypertension (62.5%), smoking (56.3%), and hyperlipidemia (46.9%).
Persistent ST elevation 3 days after a nearly transmural MI portends possible LV aneurysm. It is very unlikely to be LV aneurysm morphology when the ST elevation is so high and the T-Wave inversion is so deep. Circulation 1999;99(15):1972-7. Circulation 2000;101(2):125-30. Circulation 1998;97(23):2303-6.
Formal echo (few hours after cath): EF 49% mid anterior septum moderately hypokinetic anterior apex dyskinetic inferior apex dyskinetic septal apex akinetic apical cap dyskinetic apex dilated and dyskinetic, consistent with an aneurysm moderate apical left ventricular thrombus He survived to discharge. Circulation. hours earlier?
Total loss of circulation can lead to gangrene and loss of a limb. Aortic Aneurysms : An aneurysm is an abnormal bulge in a blood vessel wall. Vasculitis : Inflammation of blood vessels that can lead to organ damage or an aneurysm. Angioplasty & Stenting: Opens blocked arteries to improve blood flow.
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