Cardiac Aneurysms and Abnormalities

True versus False Left Ventricular Aneurysm

A false aneurysm of the left ventricle is a rare complication of myocardial infarction. A false aneurysm is a contained rupture; the wall does not contain myocardial elements. It is important to differentiate a false aneurysm from a true aneurysm, which has a wall containing myocardial elements, as a false aneurysm can rupture at any age and requires surgical repair.

Features of False Left Ventricular Aneurysms 1

Inferior or inferolateral wall location
Narrow ostium connecting aneurysm sac to ventricle
Delayed pericardial enhancement on magnetic resonance imaging (MRI)

Atrial Myxoma versus Thrombus

MRI signal characteristics are typically not useful in differentiating atrial myxomas from thrombus, as they can both be heterogeneous in signal intensity on spin echo images and hypointense on gradient echo images. However, myxomas tend to be more heterogeneous in attenuation than thrombi on computed tomography (CT).²

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