LEFT-VENTRICULAR PSEUDOANEURYSM IN A PATIENT WITH DRESSLERS-SYNDROME AFTER MYOCARDIAL-INFARCTION

Successful recanalisation of the left anterior descending coronary art ery was performed in a 51 year old man who was admitted two weeks afte r acute anterior myocardial infarction. Fourteen days later, the patie nt developed Dressier's syndrome with cardiac tamponade, which was imm ediately punctured. Sternotomy was performed after two weeks because o f progressive haemodynamic deterioration, and fibrinous masses were re moved from the pericardium. The patient recovered but two weeks later echocardiography showed a perforation of the left ventricular free wal l and formation of a pseudoaneurysm. Intensive monitoring showed signi ficant enlargement of the pseudoaneurysm, which was subsequently resec ted. This case demonstrates that dangerous formation of a pseudoaneury sm can occur not only during the first days of acute myocardial infarc tion but also after weeks in patients suffering from non-infectious pe ricarditis caused by Dressier's syndrome. Although the incidence of Dr essier's syndrome is declining, patients should be monitored carefully for several weeks, especially by echocardiography.