ECHO 2013 / Acute Coronary Syndromes Echo in the Assessment of Complications
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Subepicardial Aneurysm
A subepicardial aneurysm has a narrow neck that is formed by an abrupt interruption of the myocardial wall.
–Possibly develops when the infarcted ventricular wall partially ruptures, and that the epicardium, sometimes
with myocardial remnants, prevents complete rupture and expands under the transmitted LV pressure
The subepicardial aneurysm has a high
propensity to rupture spontaneousl
– Prompt surgical treatment is required. 
Epstein JI, Hutchins GM. Subepicardial aneurysm: a rare complication of myocardial infarction. Am J Med 1983;75: 639-43.
Complications of MI Detected by 
Echo
Hemodynamic States
–Globally reduced LV contractility
–Hypovolema
–Right ventricular infarction
–Ischemic MR
Mechanical Complications
– Papillary muscle rupture
–Ventricular septal rupture
–Free wall rupture and tamponade
Other
–Left ventricular aneurysm
–Mural thrombus
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