GATED RADIONUCLIDE ANGIOGRAPHY FOR THE DIFFERENTIAL-DIAGNOSIS OF TRUELEFT-VENTRICULAR ANEURYSM AND PSEUDOANEURYSM - A CASE-REPORT

Our purpose was to evaluate ventricular function by the use of gated r adionuclide angiography, in a patient admitted for a suspected left ve ntricular pseudoaneurysm, Our subject was a male patient aged 62 years old, who, in January of 1989, had an inferoposterior AMI; after disch arge his clinical condition worsened progressively, with dyspnea, and weight loss, We assessed ventricular function and morphology using rou tine cardiovascular noninvasive techniques as well as Doppler echocard iography, contrast ventriculography, and gated radionuclide angiograph y, Contrast ventriculography, Doppler echocardiography, and gated radi onuclide angiography indicated the presence of a left ventricular pseu doaneurysm connected through a small orifice with the ventricular cavi ty, Gated radionuclide angiography, in particular, showed an image of the ventricular cavity with a zone of paradoxical kinesis, The aneurys mal cavity was emptied during diastole, with an opposite procedure of the ventricular cavity during the cardiac cycle, Because of deteriorat ing heart failure, the patient underwent short-term surgery, and the d iagnostic suspicion was belied by the postoperative report, The new ca vity, discovered in the posteroinferior myocardial segment, was highly suggestive of a pseudoaneurism, but the postoperative report belied o ur diagnosis, These observations suggest the usefulness, and the limit ations, of the use of all the parameters that can be obtained from gat ed radionuclide ventriculography.