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A Rare Cause for Congestive Heart Failure after Myocardial Infarction: A Giant Left Ventricle Pseudoaneurysm Cover

A Rare Cause for Congestive Heart Failure after Myocardial Infarction: A Giant Left Ventricle Pseudoaneurysm

Open Access
|Mar 2026

Figures & Tables

FIGURE 1.

ECG at the moment of the crisis.

FIGURE 2.

A. Apical three-chamber view showing a left ventricular posterior wall pseudoaneurysm measuring 5.36 cm, with associated left pleural effusion. B. Color Doppler examination demonstrating communication between the left ventricular cavity and the pseudoaneurysm.

FIGURE 3.

Thoracic CT angiography showing a posterior wall left ventricular pseudoaneurysm, bilateral pleural effusion, and thrombus in the left atrial appendage. No signs of pulmonary thromboembolism are present.

FIGURE 4.

ECG showing significant bradycardia, interpreted as a vagal reaction secondary to the vomiting episode.

Laboratory findings at admission to the Cardiology Department

Laboratory findingValueReference range
D-dimers3,240 ng/ml< 500 ng/ml
Troponine49< 50
NT-proBNP35,000 pg/ml< 300 pg/ml
Glucose115 mg/dl70–110 mg/dl
Creatinine1.70 mg/dl Clearance 28.77 ml/min0.5–1.2 mg/dl
Urea29 mg/dl20–50 mg/dl
Potassium3.43 mmol/L3.5–5.1 mmol/L
C-reactive protein4.8 mg/dl0–1 mg/dl
Total protein5.9 g/dl6–8 g/dl
Albumin2.9 g/dl3.5–5.2 g/dl
Ferritin390 ng/ml10–300 ng/ml
Serum iron47 μg/dl50–175 μg/dl
Hemoglobin10 g/dl12–17 g/dl
Hematocrit31.2 g/dl36–52 g/dl
Lymphocytes19.2%20–40%
Erythrocyte sedimentation rate30 mm/h6–12 mm/h
International normalized ratio1.060.8–1.2

Paraclinical investigations on day 23 of hospitalization

Laboratory findingValueReference range
White blood cells16.67 × 109/L4–40
Neutrophils82.9%50–75
Lymphocytes10%20–40
Hemoglobin11.8 g/dl12–17
Ferritin530 ng/ml10–300
C-reactive protein5.2 mg/dl0–1
Creatinine1.81 mg/dl, eGFR 26.49 ml/min/1.73 m20.5–1.2
Albumin3.3 g/dl3.5–5.2
Glucose240 mg/dl70–110
Total bilirubin0.57 mg/dl<1
Direct bilirubin0.02 mg/dl<0.4
Amylase26 U/L0–100
Abdominal ultrasoundDilated gallbladder with markedly thickened, echogenic walls and multiple gallstones.Liver with normal echogenicity and no focal lesions.No dilatation of the intrahepatic bile ducts.Portal vein and common bile duct of normal caliber.Pancreas, spleen, and kidneys within normal limits.
DOI: https://doi.org/10.2478/jce-2026-0004 | Journal eISSN: 2457-5518 | Journal ISSN: 2457-550X
Language: English
Page range: 44 - 51
Submitted on: Aug 10, 2025
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Accepted on: Dec 15, 2025
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Published on: Mar 27, 2026
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2026 Diana Irimie, Bogdan Caloian, Gabriel Cismaru, Dana Pop, published by Asociatia Transilvana de Terapie Transvasculara si Transplant KARDIOMED
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.