Rupture of Left Ventricular Aneurysm in Infant: Case Report.
Andriy A Pereyaslov, Bohdan Malovanyy, Iryna I Hoshovska et al.
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Case in brief
A preterm infant hospitalized from birth with necrotizing enterocolitis, later complicated by ascending-colon narrowing requiring surgery, had persistent infections with Staphylococcus haemolyticus and then Staphylococcus epidermidis. Earlier echocardiograms showed no significant changes, but the final study identified a structure connected to the left ventricular cavity. The infant developed sudden cardiac arrest with significant pericardial effusion. Resuscitation and emergency pericardiocentesis did not prevent recurrent asystole, and the infant died. Autopsy found an anterior left ventricular outpouching with myocardial thinning and a linear rupture; histology showed myocardium and connective tissue with inflammation, necrosis, and hemorrhage.
What made this case unusual
The aneurysm was not clearly identified on earlier echocardiograms; rupture with significant pericardial effusion became apparent only at the terminal event, and the diagnosis was established at autopsy.
Diagnostic / clinical pearl
In an infant with sudden cardiac arrest and significant pericardial effusion, a ruptured ventricular aneurysm is a possible cause, even when earlier echocardiograms have shown no significant changes.