Heart wall aneurysm
As Heart wall aneurysm (ventricular aneurysm), the physician refers to a bulge formed on the heart wall. The cardiac wall aneurysm occurs predominantly in the left ventricle. The cardiac wall aneurysm is not a classic disease; it is mainly one of the late complications after a heart attack. If the aneurysm breaks, there is an acute danger to life.
Table of Contents
What is a cardiac wall aneurysm?
Heart wall aneurysms usually form in the left ventricle. The danger of that Heart wall aneurysm arises, is given especially after a heart attack. In about 20 percent of all patients who have suffered a heart attack, the heart wall aneurysm is subsequently diagnosed.
The physicians distinguish between the chronic and acute cardiac wall aneurysm. If the patient suffers from a heart attack, necrosis / scarring occurs, which mainly develops in the myocardium of the heart. These neoplasms are stretched by the pressure of the chamber, with the heart wall subsequently evading.
The blood remains in the protuberance and thickened (thrombi). The danger? The thrombi can enter the systemic circulation or the brain, leading to gastrointestinal tract, kidney or brain infarctions.
As a rule, it is a major reduction in the output. The heart wall, which is already locally provided with strong scar tissue, the pressure that is upright in the ventricle, not 100 percent withstand, so it comes to an expansion.
It creates a kind of bulge, which causes the blood to collect and not be able to clot. If there is a thickening of the blood, it is called thrombi. It forms clots that migrate into the systemic circulation or into the brain and subsequently clogged vessels.
Symptoms, complaints & sign
Heart wall aneurysms, especially at the beginning of their development, provide no complaints. Patients usually complain of discomfort only when the dilatation has progressed so far that the blood vessel is already pressing on the organs.
Typical symptoms include difficulty in swallowing, hoarseness, coughing, breathing difficulties and circulatory disorders, which mainly occur in the arms. Subsequently, cardiac arrhythmias or cardiac insufficiency may be symptoms that suggest a cardiac wall aneurysm.
diagnosis & disease
Physicians determine cardiac aneurysms primarily in the context of follow-up after heart attacks. This is because after cardiac infarcts regular check-ups of the heart take place. The physician can therefore determine via cardiac ultrasound (echocardiography) whether a cardiac wall aneurysm has been formed or not.
If the physician is uncertain or wants to confirm the diagnosis 100 percent, magnetic resonance imaging (MRI) can provide the necessary results. The physician also receives information about the position, the flow and the size of the cardiac wall aneurysm. That information is also crucial for further therapy.
If there is a cardiac wall aneurysm, there is an impairment in the pumping function of the heart, so that it comes to a reduced ejection performance. The physician recognizes, in the area of the Herzwandaneurysmas, disorder anomalies that favor the so-called thrombi. If the formed thrombi are transported into the vascular system, embolisms can occur.
In extremely severe cases there is also the possibility that the heart wall tears (ventricular rupture). The blood subsequently comes out of the heart, flows into the pericardium and provides for cardiac compression. Such complications lead to the death of the patient in almost all cases. Other cardiac wall aneurysm complications include left ventricular failure with cardiogenic shock or cardiac arrhythmias.
A cardiac wall aneurysm affects the pumping capacity of the heart. The weakened ejection of blood from the heart favors the formation of thrombi, blood clots that affect blood circulation and supply to the body. If the blood vessel is completely closed by the thrombus, an embolism occurs. This can lead to death.
A second dangerous complication arises when the cardiac wall aneurysm ruptures and fluid accumulates. This so-called cardiac tamponade exerts pressure on vital functions and hinders the contraction movement of the heart. The death rate is very high in such cases, as the fluid can rarely be removed quickly enough by puncture and drainage.
The cardiac wall aneurysm is often accompanied by cardiac arrhythmias and left ventricular failure, which also need to be treated. Otherwise, these sequelae may lead to cardiogenic shock due to a lack of oxygen supply. An operative removal is only possible with a suitable position of the cardiac wall aneurysm.
When should you go to the doctor?
A visit to a doctor is advisable as soon as irregularities in the heart activity occur. In case of disturbances of the heart rhythm, an unexplained rapid heart rate or a persistent hypertension a doctor should be consulted. If sweats, flushes or an inner restlessness, the cause should be determined by a doctor. Sleep disturbances, respiratory complaints, a feeling of pressure in the chest, pain and dizziness should be examined and treated.
If you experience trouble swallowing and have coughing or hoarseness, consult a doctor. If the irregularities result in denial of food or hydration, a doctor is needed. The victim is threatened with a shortage of the organism, which must be medically treated. In circulatory disorders in the limbs, special care must be taken. If the person suffering repeatedly suffers from cold fingers, hands or feet, a follow-up examination is recommended. If unfamiliar heart problems occur in physical stress situations, this observation should be discussed with a doctor.
Since the cardiac wall aneurysm often shows no strong symptoms at the beginning of the disease, but the symptoms only become apparent at an advanced stage, a visit to the doctor should be made at the first noticeable signs. The sooner the person concerned calls on a doctor, the better the treatment options.
treatment & therapy
The therapy depends mainly on the size and location of the cardiac wall aneurysm. Basically, cardiac wall aneurysms can be treated surgically and conservatively. If the physician has diagnosed a major cardiac wall aneurysm, it should be surgically treated due to the risk of rupture and recurrent embolism.
Finally, if it is a large cardiac wall aneurysm, there is a risk that it will rupture, so that the patient’s life is in danger. If the physician decides to undergo surgery, various surgical methods are available. On the one hand, he can decide to use a vascular prosthesis, on the other hand use a stent in the affected vessel.
Another option is the so-called DOR plastic. The heart is exposed and subsequently the cardiac wall aneurysm is displayed and opened. In the further course of the operation, the physician examines those parts of the heart wall which are responsible for the thinning.
In doing so, the physician removes the aneurysmal tissue and, if appropriate, can also attach a patch to the defect that originated from the cardiac wall aneurysm. If the physician has diagnosed a small cardiac wall aneurysm that causes no discomfort, he decides primarily for the conservative treatment.
Risk factors such as lipid metabolism disorders, high blood pressure, an unhealthy diet or nicotine consumption are primarily tackled. If the patient reduces the risk factors, he can ensure that the cardiac wall aneurysm remains unchanged, so that no surgery is required.
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view & forecast
The cardiac wall aneurysm is a dangerous condition with poor prognosis, unless the patient is treated surgically. As with any aneurysm, the cardiac wall aneurysm may be at risk of the heart wall already thinning to such an extent that a more or less large tear develops and severe internal bleeding occurs. Because the heart muscle is heavily perfused, this complication can be fatal if the affected person can not be operated on immediately. Prerequisite for healing is the restoration of the thinned tissue, which is why the cardiac wall aneurysm could arise in the first place. If this succeeds and heals the sutures after surgery without major complications, then the patient can fully recover from a cardiac wall aneurysm.
Another decisive factor for an accurate prognosis is the question of how thinning of the heart wall could occur. If there is an underlying disease that damages the heart wall, it may not be ruled out that it will return to such a condition. Often a cardiac wall aneurysm develops as a result of a heart attack and is very susceptible to life-threatening ruptures the day after. But if the patient survives the critical first day, his chances of recovery improve as well. Any cardiac wall aneurysm also carries the risk of clot formation, which can lead to dangerous thrombosis and other complications.
A cardiac wall aneurysm can only be prevented to a limited extent. Since it is mainly a late episode of a heart attack, it is therefore even more important that it does not even come to a heart attack. Lack of exercise, overweight, nicotine consumption, unhealthy diet – all factors that favor a heart attack (and subsequently the cardiac wall aneurysm).
The follow-up measures in a cardiac wall aneurysm usually depend very much on the time of diagnosis and on the severity of the disease, so that no general prognosis can be made. However, an early detection of the complaint always has a positive effect on the further course and can also prevent further complications and complaints.
In the worst case, the heart wall aneurysm can lead to the death of the person affected, so that a doctor should be contacted at the first symptoms and signs of the disease. The treatment of the disease is usually done by a surgical procedure, which runs without any special complications. The person should rest after the procedure and not strain the body.
In doing so, one must refrain from physical and sporting activities so as not to burden the body unnecessarily. Similarly, a healthy lifestyle with a well-balanced diet generally has a very positive effect on the course of the cardiac wall aneurysm. Oily food should be avoided to avoid high blood pressure. Even after a successful procedure, further examinations of the heart are very important. Maybe it comes through the heart wall aneurysm to a reduced life expectancy of the person affected.
You can do that yourself
Patients with a cardiac wall aneurysm are always following the instructions of the treating specialist because it is a serious condition that can cause serious complications at any time. The possibilities for self-help of the affected persons depend above all on the type of therapy. In conservative treatment, it is particularly important to reduce known risk factors and thus avoid surgery.
By reducing high blood pressure and body weight, reducing cigarettes, and dieting in a healthy way, the patient with cardiac wall aneurysm improves well-being and quality of life. At the same time, the patient reduces the likelihood that the cardiac wall aneurysm will require surgical treatment.
In the case of surgery, the person concerned tries to increase the success of the surgical procedure and its chances of recovery by adequate preparation. In doing so, he focuses primarily on the instructions of the doctor. Even before the operation, it is advisable to switch to a healthy lifestyle and to refrain from physical stress and to minimize mental stress. After the procedure, the patient initially remains in inpatient care and retains extensive rest periods, which serve to regenerate. A light, gentle on the heart, the patient keeps on at home.
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