A crescent-shaped image in the heart: calcified thrombosed left ventricular aneurysm.

摘要

A 60-year-old woman, who had a smoking habit of 30 cigarettes per day, was admitted for evaluation of effort angina and shortness of breath. Her medical history was unremarkable except for a syncopal episode experienced 15 years before that had not been investigated. Electrocardiographic tracings showed evidence of an old anterior myocardial infarction. Chest radiographs showed a peculiar crescent-shaped calcification enclosed within an abnormal cardiac silhouette, which suggested a left ventricular (LV) aneurysm containing an extensively calcified mural thrombus (Fig. 1). A transthoracic echocardiogram revealed a hyper-reflective aneurysm of the LV involving the apex, the septum, and the inferior wall, with a large calcified mural thrombus in the ventricular cavity. A coronary arteriogram showed an occlusion of the mid portion of the anterior branch of the left coronary artery and a critical stenosis of the proximal circumflex coronary artery.