Left ventricular aneurysm pathophysiology

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Left ventricular aneurysm Microchapters


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Differentiating Left ventricular aneurysm from other Diseases

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]


Aneurysms form when the intraventricular tension stretches the non contracting, infarcted heart muscle, resulting in an expansion of the thin layer of necrotic muscle and fibrous tissue, which bulges with each cardiac contraction. The wall of a mature aneurysm is a white fibrous scar. It becomes more densely fibrotic as the time passes, and bulges outward with each cardiac contraction, resulting in a reduction of the left ventricular stroke volume. On microscopy, hyalinized fibrous tissue is the predominant finding. It usually takes 1 month for fibrous tissue to form.


Microscopic findings

  • Hyalinized fibrous tissue is the predominant finding.
    • However, a small number of viable muscle cells are also usually present.[1]
  • It usually takes 1 month for fibrous tissue to form.
    • Collagen tissue is formed during the first 10 days.
    • When an aneurysm is present within 1 week of a first myocardial infarction, the wall is composed largely of necrotic muscle and it is therefore not a true aneurysm by definition.[2]

Gross Pathology


The gross pathologic features of LV aneurysm are shown below.[4]


  1. Gorlin R, Klein MD, Sullivan JM (1967). "Prospective correlative study of ventricular aneurysm. Mechanistic concept and clinical recognition". Am. J. Med. 42 (4): 512–31. PMID 6024720.
  2. PHARES WS, EDWARDS JE, BURCHELL HB (1953). "Cardiac aneurysms; clinicopathologic studies". Proc Staff Meet Mayo Clin. 28 (9): 264–71. PMID 13056012.
  3. Dubnow MH, Burchell HB, Titus JL (1965). "Postinfarction ventricular aneurysm. A clinicomorphologic and electrocardiographic study of 80 cases". Am. Heart J. 70 (6): 753–60. PMID 5842520.
  4. Images courtesy of Professor Peter Anderson DVM PhD and published with permission. © PEIR, University of Alabama at Birmingham, Department of Pathology

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