Successful management of a delayed-presented and complicated right ventricular pseudoaneurysm: a case report and literature review
Abstract Introduction Right ventricle (RV) pseudoaneurysm is a substantially rare but fatal condition that should be diagnosed promptly to prevent severe complications, such as rupture and death. However, due to its nonspecific presentation, its diagnosis relies mainly on advanced imaging cardiac mo...
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| Format: | Article |
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BMC
2025-08-01
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| Series: | Journal of Cardiothoracic Surgery |
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| Online Access: | https://doi.org/10.1186/s13019-025-03566-9 |
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| author | Fariba Bayat Ramin Baghaei Tehrani Mohammad Khani Tooba Akbari Taraneh Faghihi Langroudi Maryam Taheri Amirhesam Alirezaei Amin Bagheri Pouya Ebrahimi |
| author_facet | Fariba Bayat Ramin Baghaei Tehrani Mohammad Khani Tooba Akbari Taraneh Faghihi Langroudi Maryam Taheri Amirhesam Alirezaei Amin Bagheri Pouya Ebrahimi |
| author_sort | Fariba Bayat |
| collection | DOAJ |
| description | Abstract Introduction Right ventricle (RV) pseudoaneurysm is a substantially rare but fatal condition that should be diagnosed promptly to prevent severe complications, such as rupture and death. However, due to its nonspecific presentation, its diagnosis relies mainly on advanced imaging cardiac modalities. This report describes the successful management of a delayed and unusual presentation of RV pseudoaneurysm. Case presentation A 31-year-old white male patient with a history of pericardiectomy presented with chest pain and dyspnea, which worsened by exertion, and edema of the lower extremities, which had started several weeks ago and had been exacerbated over time. The initial evaluations with cardiac enzyme check, chest X-ray, and electrocardiogram were unremarkable, and the patient was planned to undergo a transthoracic echocardiogram (TTE). TTE revealed RV failure and increased RV diameter; a suspicious lesion in the RV apex was also detected, suggesting a pseudoaneurysm. Cardiac Computed Tomography (CTA) confirmed the diagnosis, and interventional treatment via an Amplatzer device was considered, which was rejected by the interventional cardiologist of the center due to the lack of experience and logistics for such intervention. Considering the patient’s condition deterioration, the patient was transferred to an operating room, and an open-heart surgery was performed to suture the ruptured RV myocardium. The pericardial effusion was removed. The histopathological evaluation of the sample confirmed the diagnosis. The post-surgical recovery and follow-up were uneventful. The graphical abstract is added below to illustrate the case and summarize it. Conclusion (Clinical key point) Right ventricle pseudoaneurysms can present with unusual symptoms and signs, and misdiagnosis is highly probable. Advanced imaging techniques after the initial echocardiogram might be necessary to confirm the diagnosis. Moreover, timely, appropriate, and wisely chosen treatment (interventional or surgical) can result in uneventful treatment and recovery. Graphical abstract |
| format | Article |
| id | doaj-art-c5b6dcd5ee2d44b7beab5afc2082b81d |
| institution | DOAJ |
| issn | 1749-8090 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj-art-c5b6dcd5ee2d44b7beab5afc2082b81d2025-08-20T03:06:05ZengBMCJournal of Cardiothoracic Surgery1749-80902025-08-0120111110.1186/s13019-025-03566-9Successful management of a delayed-presented and complicated right ventricular pseudoaneurysm: a case report and literature reviewFariba Bayat0Ramin Baghaei Tehrani1Mohammad Khani2Tooba Akbari3Taraneh Faghihi Langroudi4Maryam Taheri5Amirhesam Alirezaei6Amin Bagheri7Pouya Ebrahimi8Cardiovascular Research Center, Shahid Beheshti University of Medical SciencesCardiac Surgery Department, School of Medicine, Modarres Hospital, Shahid Beheshti University of Medical SciencesCardiovascular Research Center, Shahid Beheshti University of Medical SciencesCardiovascular Research Center, Shahid Beheshti University of Medical SciencesRadiology Department, Modarres Hospital, Shahid Beheshti University of Medical SciencesCardiovascular Disease Research Institute, Tehran Heart Center, Tehran University of Medical SciencesDepartment of Nephrology, Clinical Research Development Center at Shahid Modarres Hospital, Shahid Beheshti University of Medical SciencesCardiovascular Research Center, Shahid Beheshti University of Medical SciencesDepartment of Cardiology, University Hospitals Birmingham NHS Foundation TrustAbstract Introduction Right ventricle (RV) pseudoaneurysm is a substantially rare but fatal condition that should be diagnosed promptly to prevent severe complications, such as rupture and death. However, due to its nonspecific presentation, its diagnosis relies mainly on advanced imaging cardiac modalities. This report describes the successful management of a delayed and unusual presentation of RV pseudoaneurysm. Case presentation A 31-year-old white male patient with a history of pericardiectomy presented with chest pain and dyspnea, which worsened by exertion, and edema of the lower extremities, which had started several weeks ago and had been exacerbated over time. The initial evaluations with cardiac enzyme check, chest X-ray, and electrocardiogram were unremarkable, and the patient was planned to undergo a transthoracic echocardiogram (TTE). TTE revealed RV failure and increased RV diameter; a suspicious lesion in the RV apex was also detected, suggesting a pseudoaneurysm. Cardiac Computed Tomography (CTA) confirmed the diagnosis, and interventional treatment via an Amplatzer device was considered, which was rejected by the interventional cardiologist of the center due to the lack of experience and logistics for such intervention. Considering the patient’s condition deterioration, the patient was transferred to an operating room, and an open-heart surgery was performed to suture the ruptured RV myocardium. The pericardial effusion was removed. The histopathological evaluation of the sample confirmed the diagnosis. The post-surgical recovery and follow-up were uneventful. The graphical abstract is added below to illustrate the case and summarize it. Conclusion (Clinical key point) Right ventricle pseudoaneurysms can present with unusual symptoms and signs, and misdiagnosis is highly probable. Advanced imaging techniques after the initial echocardiogram might be necessary to confirm the diagnosis. Moreover, timely, appropriate, and wisely chosen treatment (interventional or surgical) can result in uneventful treatment and recovery. Graphical abstracthttps://doi.org/10.1186/s13019-025-03566-9Cardiac imagingCardiac surgeryCase reportEchocardiographyPseudoaneurysmRight ventricle |
| spellingShingle | Fariba Bayat Ramin Baghaei Tehrani Mohammad Khani Tooba Akbari Taraneh Faghihi Langroudi Maryam Taheri Amirhesam Alirezaei Amin Bagheri Pouya Ebrahimi Successful management of a delayed-presented and complicated right ventricular pseudoaneurysm: a case report and literature review Journal of Cardiothoracic Surgery Cardiac imaging Cardiac surgery Case report Echocardiography Pseudoaneurysm Right ventricle |
| title | Successful management of a delayed-presented and complicated right ventricular pseudoaneurysm: a case report and literature review |
| title_full | Successful management of a delayed-presented and complicated right ventricular pseudoaneurysm: a case report and literature review |
| title_fullStr | Successful management of a delayed-presented and complicated right ventricular pseudoaneurysm: a case report and literature review |
| title_full_unstemmed | Successful management of a delayed-presented and complicated right ventricular pseudoaneurysm: a case report and literature review |
| title_short | Successful management of a delayed-presented and complicated right ventricular pseudoaneurysm: a case report and literature review |
| title_sort | successful management of a delayed presented and complicated right ventricular pseudoaneurysm a case report and literature review |
| topic | Cardiac imaging Cardiac surgery Case report Echocardiography Pseudoaneurysm Right ventricle |
| url | https://doi.org/10.1186/s13019-025-03566-9 |
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