According to abbreviationfinder.org, the physician describes a bulge that has formed on the heart wall as a heart wall aneurysm ( ventricular aneurysm ). Heart wall aneurysms occur primarily in the left ventricle. The heart wall aneurysm is not a classic disease; it is primarily one of the late complications after a heart attack. If the aneurysm ruptures, there is an acute danger to life.
What is a heart wall aneurysm?
Heart wall aneurysms usually form in the left ventricle. The risk of developing a heart wall aneurysm is particularly high after a heart attack. Around 20 percent of all patients who have suffered a heart attack are subsequently diagnosed with a heart wall aneurysm.
Doctors distinguish between chronic and acute heart wall aneurysms. If the patient suffers a myocardial infarction, necrosis /scar formation occurs as a further consequence, which mainly occurs in the myocardium of the heart. These new growths are stretched by the chamber pressure, which causes the heart wall to bulge.
The blood remains in the bulge and thickens ( thrombi ). The danger? The thrombi can enter the systemic circulation or the brain, resulting in gastrointestinal, kidney or cerebral infarction.
Causes
Cardiac wall aneurysms are usually caused by ischemic heart disease. Doctors speak of ischemic heart disease when several smaller or larger heart attacks have already occurred and scar tissue has formed, so that the heart’s pumping capacity is already impaired.
As a rule, it is a matter of a strong reduction in the ejection capacity. The heart wall, which is already covered with thick scar tissue in places, cannot 100 percent withstand the pressure that is maintained in the ventricle, so that it expands.
A kind of bulge develops, which causes the blood to pool and no longer be able to clot. If the blood thickens, it is called a thrombus. Blood clots form, which migrate into the systemic circulation or the brain and subsequently clog vessels.
Symptoms, Ailments & Signs
Cardiac wall aneurysms do not cause any symptoms, especially at the beginning of their development. As a rule, patients only complain about symptoms when the enlargement has progressed so far that the blood vessel is already pressing on the organs.
The typical symptoms include swallowing difficulties, hoarseness, coughing, breathing difficulties and also circulatory disorders, which mainly occur in the arms. As a result, cardiac arrhythmia or cardiac insufficiency can be symptoms that suggest a heart wall aneurysm.
Diagnosis & course of disease
Doctors primarily identify heart wall aneurysms during check-ups after heart attacks. This is because the heart is checked regularly after a heart attack. The doctor can therefore use the heart ultrasound ( echocardiography ) to determine whether a heart wall aneurysm has formed or not.
If the doctor is unsure or would like to confirm the diagnosis 100 percent, magnetic resonance imaging (MRI) can provide the necessary results. The doctor also receives information about the location, flow and size of the heart wall aneurysm. This information is also crucial for further therapy.
If there is a heart wall aneurysm, the pumping function of the heart is impaired, resulting in a reduced ejection capacity. The doctor recognizes, in the area of the heart wall aneurysm, anomalies that favor the so-called thrombi. If the formed thrombi are transported into the vascular system, embolism can occur.
In extremely severe cases, there is also the possibility that the heart wall tears (ventricular rupture). The blood then exits the heart, flows into the pericardium, and compresses the heart. Such complications lead to the death of the patient in almost all cases. Other complications that can occur as part of a heart wall aneurysm are left ventricular failure with cardiogenic shock or cardiac arrhythmia.
Complications
The heart wall aneurysm itself arises as a complication of the heart attack and is therefore not a classic disease. As such, it can be predicted comparatively well if appropriate preventive examinations are carried out. If the symptoms only start very late, the diagnosis is made more difficult and the disease can progress to a critical point.
A heart wall aneurysm impairs the heart’s ability to pump blood. The weakened ejection of blood from the heart promotes the formation of thrombi, blood clots, which impair blood circulation and supply to the body. If the blood vessel is completely blocked by the thrombus, an embolism occurs. This can lead to death.
A second dangerous complication arises when the heart wall aneurysm ruptures and fluid builds up. This so-called cardiac tamponade puts pressure on vital functions and impedes the contraction movement of the heart. The death rate is very high in such cases because the fluid can rarely be drained quickly enough through the puncture and drainage.
The heart wall aneurysm is often accompanied by cardiac arrhythmia and left ventricular failure, which also need to be treated. Otherwise, these consequences may lead to cardiogenic shock due to a lack of oxygen supply. Surgical removal is only possible if the heart wall aneurysm is in a suitable location.
When should you go to the doctor?
A doctor’s visit is advisable as soon as irregularities in heart activity occur. A doctor should be consulted in the event of cardiac arrhythmia, an unexplained tachycardia or persistent high blood pressure. If sweating, hot flashes or inner turmoil occur, the cause should be determined by a doctor. Sleep disturbances, breathing difficulties, chest pressure, pain, and dizziness should be evaluated and treated.
If you have problems swallowing and you develop a cough or hoarseness, you should consult a doctor. If the irregularities lead to a refusal to eat or drink, a doctor is needed. The person concerned is threatened with an undersupply of the organism, which must be treated medically. Particular caution should be exercised in the event of circulatory disorders in the limbs. If the person concerned repeatedly suffers from cold fingers, hands or feet, a check-up is recommended. If unusual heart problems occur in physical stress situations, this observation should be discussed with a doctor.
Since the heart wall aneurysm often does not show any strong symptoms at the beginning of the disease, but the symptoms only become clear in the advanced stage, a doctor should be consulted as soon as the first noticeable signs are noticed. The sooner the person concerned sees a doctor, the better the treatment options are.
Treatment & Therapy
The therapy depends primarily on the size and location of the heart wall aneurysm. In principle, heart wall aneurysms can be treated surgically and conservatively. If the doctor has diagnosed a large heart wall aneurysm, this should be treated surgically due to the risk of rupture and recurrent embolism.
Finally, if the aneurysm is large, there is a risk that it will rupture, putting the patient’s life at risk. If the doctor decides to have an operation, there are various surgical methods available. On the one hand he can decide to use a vascular prosthesis, on the other hand he can insert a stent into the affected vessel.
Another option is the so-called DOR plastic. The heart is exposed and then the heart wall aneurysm is exposed and opened. In the further course of the operation, the doctor examines those areas of the heart wall that are responsible for the thinning.
The doctor removes the aneurysmal tissue and, if necessary, can also attach a patch to the defect that originated from the heart wall aneurysm. If the doctor has diagnosed a small heart wall aneurysm that does not cause any symptoms, he primarily opts for conservative treatment.
Risk factors such as dyslipidemia, high blood pressure, an unhealthy diet or nicotine consumption are primarily tackled. If the patient reduces the risk factors, he can ensure that the heart wall aneurysm remains the same size, so that surgery is not necessary.
Outlook & Forecast
Cardiac wall aneurysm is a dangerous condition with a poor prognosis unless the patient is treated surgically. As with any aneurysm, there is also a risk with a heart wall aneurysm that the heart wall has already thinned so much that a more or less large tear occurs and severe internal bleeding occurs. Since the heart muscle is heavily supplied with blood, this complication can be fatal if the affected person cannot be operated on immediately. The prerequisite for healing is the restoration of the thinned tissue, which is why the heart wall aneurysm could develop in the first place. If this is successful and the sutures heal after the surgical procedure without major complications, the patient can fully recover from a heart wall aneurysm.
The decisive question for an accurate prognosis is how the heart wall could have thinned. If there is an underlying disease that damages the heart wall, it may not be possible to rule out that such a condition will occur again. A heart wall aneurysm often develops as a result of a heart attack and is very susceptible to life-threatening ruptures the day after. However, if the patient survives the critical first day, his chances of recovery improve. Any cardiac wall aneurysm also carries the risk of clot formation, which can lead to dangerous thrombosis and other complications.
Prevention
A heart wall aneurysm can only be prevented to a limited extent. Since it is mainly a late consequence of a heart attack, it is all the more important that a heart attack does not occur in the first place. Lack of exercise, obesity, nicotine consumption, unhealthy diet – all factors that promote a heart attack (and subsequently the heart wall aneurysm).
Aftercare
The further follow-up measures for a heart wall aneurysm usually depend very much on the time of diagnosis and the severity of this disease, so that no general prediction can be made. However, 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 concerned, so that a doctor should be contacted as soon as the first symptoms and signs of the disease appear. The disease is usually treated by an operative intervention, which proceeds without any particular complications. The affected person should rest after the procedure and not strain the body.
Physical and sporting activities should be avoided in order not to put unnecessary strain on the body. In general, a healthy lifestyle with a balanced diet also has a very positive effect on the course of the heart wall aneurysm. Fatty food should be avoided to avoid high blood pressure. Even after a successful procedure, further examinations of the heart are very important. The life expectancy of the affected person may be reduced as a result of the cardiac wall aneurysm.
You can do that yourself
Patients with a heart wall aneurysm always follow the instructions of the treating specialist, since it is a serious disease in which serious complications are possible at any time. The possibilities for self-help of those affected depend primarily on the type of therapy. Conservative treatment is primarily about reducing known risk factors and thus avoiding surgical intervention.
By reducing high blood pressure and body weight, stopping cigarette smoking and making healthy diet changes, the patient with a heart wall aneurysm improves their well-being and quality of life. At the same time, the patient reduces the likelihood that surgical treatment will be necessary for the heart wall aneurysm.
In the case of an operation, the person concerned tries to increase the success of the surgical intervention and his chances of recovery by adequate preparation. In doing so, he orients himself primarily to the instructions of the doctor. Even before the operation, it is advisable to switch to a healthy lifestyle, avoid physical exertion and minimize mental stress. After the procedure, the patient initially remains in inpatient care and has extended rest periods that serve to regenerate. The patient continues to follow a light, heart-friendly diet at home.
