Cirrhosis of the Liver and Myocardial Infarction
A 65-year-old man from Uruguay has a history of cirrhosis of the liver and a prior myocardial infarction. The echocardiogram (Videos 50-1 to 50-5) is done as part of a pre-liver transplant screening evaluation.
QUESTION 1. The echocardiogram findings are consistent with:
A. Chagas disease
B. Inferolateral wall pseudoaneurysm
C. A true inferolateral wall aneurysm
D. Pseudodyskinesis of the inferolateral wall
View Answer
ANSWER 1: C. True aneurysms generally have a wide mouth, whereas pseudoaneurysms generally have a narrow neck, as shown in Figure 50-1.
 Figure 50-1. |
QUESTION 2. You recommend:
A. Urgent surgery
B. Medical management
C. Another test
View Answer
ANSWER 2: B. Medical management is the appropriate choice. Another test is okay if you are not sure. If you are uncertain about the diagnosis, additional testing could include a contrast echocardiogram, computed tomography, or magnetic resonance imaging scan with contrast.
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