A left ventricular aneurysm is a bulge or ballooning of a weakened area of the heart. The left lower chamber of the heart (left ventricle) pumps blood returning from the lungs to the rest of the body.
A heart attack can cause some of the heart muscle to die. When part of the heart muscle dies, a scar usually forms where the heart was damaged. Sometimes the scar thins and stretches. It bulges outward much like a weak spot on a car tire. Unlike the tire, it rarely bursts, but its location and size may greatly reduce the heart's pumping ability. This bulge is called a left ventricular aneurysm.
Up to 25% of people with a large area of heart muscle death from a heart attack develop aneurysms. The aneurysms range from very small (thumbnail size) to huge (doubling the size of the heart). Aneurysms usually form and get bigger during the first few months after a heart attack. Why they form in some people and not in others is not known.
A left ventricular aneurysm does not cause any symptoms.
The aneurysm is usually found with an echocardiogram, a test that uses ultrasound waves to take pictures of the heart. Your provider will measure its size and its effect on the ability of the heart muscle to squeeze.
You may need a procedure called cardiac catheterization. For this test a long, thin tube is guided through the blood vessels into the heart. X-ray movies of dye flowing through the heart can outline the aneurysm and the coronary arteries. The test gives detailed information about the inner workings of the heart.
Many left ventricular aneurysms are small and don’t need treatment.
A large ventricular aneurysm may make it harder for your heart to pump blood to the rest of the body—a problem called heart failure. Your healthcare provider may prescribe medicines for heart failure and you may need to eat a low-salt diet.
Blood clots often form in left ventricular aneurysms. Fragments of these clots sometimes break away and are carried through the bloodstream to other organs. They may become stuck in the blood vessels and cause strokes or other organ damage. You may need to take anticoagulant medicine (blood thinners) to prevent blood clots.
Often people with heart aneurysms also have heart rhythm problems, such as a problem called ventricular tachycardia. You may receive medicines to treat this problem, or you may have a device called a defibrillator put in.
Some aneurysms may be prevented if a heart attack is treated very soon after it starts.
