Treatment of Heart Aneurysm

Treatment of heart aneurysm in Israel is carried out in Israel at the Cardiology department of Herzliya Medical Center. Cardiologists treat patients by applying the latest advances in the field of open-heart surgery, significantly expanding options for patients regarding surgical procedures and the treatment of an aneurysm.

What is a heart aneurysm?

An aneurysm of the heart is characterized by the expanding and bulging of thinned heart vessels; under high pressure, this can be incredibly dangerous if ruptured. Heart aneurysms commonly occur within:

• The left ventricle of the heart
• Atrial or ventricular walls of the heart (lesions in other areas of the heart are very rare)

A heart aneurysm develops in areas of the heart that are considered “weak” muscle and that which is under high pressure inside the heart’s chambers. For example, atrial septal aneurysm develops in the (patent) foramen ovale, the septum of the heart where the muscle layer is very thin. Additional factors in the development of an atrial septal aneurysm are high-pressure differences between the left and right atria (protrusion occurs in the right atrium where pressure is significantly lower). An aneurysm of the left ventricle and interventricular septum of the heart is often the result of extensive myocardial infarction, most often caused by chronic ischemic or degenerative processes.

Heart Aneurysm Symptoms

The clinical severity of the heart aneurysm depends on its location and size. Often, a sharp deterioration in the patient’s hemodynamic parameters is measured to determine it is that of the acute or subacute stage(s). Myocardial infarction (heart attack) may indicate the presence of an aneurysm. Main symptoms and complications are highlighted:

• Rupture of the heart in place of the aneurysm and cardiac tamponade. This is among the most serious causes and requires urgent (emergency) surgical intervention to maintain health and if not treated, may be life-threatening in a matter of minutes
• Heart failure due to decreased myocardial contractility. The aneurysm in these cases are not involved in the reduction of negative impact on global systolic function
• Arrhythmias defeat nodes and branches of the conduction system of the heart in the area of ​​the aneurysm. For example, an atrial septal aneurysm is often accompanied by atrial fibrillation or supraventricular tachycardia. If an aneurysm is located near the left ventricle, a form of interventricular conduction or ectopic heart function may blockade it
• Thrombotic complications are caused by stagnated blood in the aneurysm, or as a consequence of cardiac arrhythmias. Mural thrombus (thrombi that attach to the heart lining) prone to decay, can cause severe thromboembolic complications, predominantly in the pool of blood vessels of the brain (ischemic stroke)

Heart Aneurysm Diagnosis at HMC

At Herzliya Medical Center in Israel, experts use the latest tools of cardiology diagnostics for assessment, allowing accurate identification of aneurysm and its complications. Echocardiography (through a study of the chest wall – transesophageal) also helps to characterize the heart aneurysm.

In addition, assessment of the myocardium and its functional capacity is aided by echocardiography to determine not only the presence but also the size of the parietal thrombus. When necessary, patients at HMC are screened using:

• Tomographic imaging of the heart (cardio-CT)
• Isotope scanning
• Heart rate monitoring
• Coronary catheterization

Conservative Treatment of Heart Aneurysm at HMC

This applies to small heart aneurysms, most often using the following methods:

• Control of blood pressure in patients with primary (essential) hypertension
• Treatment of heart failure caused by aneurysm or disease by way of medical monitoring of symptoms to reduce exertion of the heart and prevent further growth of the aneurysm
• Antiarrhythmic treatment
• Prevention education for patients about the mural thrombus and thromboembolic complications

Effective drug control symptoms for heart aneurysm vastly improve patient prognosis, however, the current treatment of this type cannot eliminate mechanical defect in the heart and damage to the muscle wall, nor is complete prevention possible – patients may remain at risk of complications.

Heart Aneurysm surgery at HMC

At HMC in Israel, heart aneurysm surgery is suggested for patients who display symptoms or develop a need for the following:

• Emergency surgery for suspected aneurysm rupture (usually in acute or subacute phases of myocardial infarction )
• Chronic aneurysm patients who develop symptoms of heart failure
• Mural thrombus formation in patients with a form of a heart aneurysm. Surgery is indicated for those considered at high risk of thromboembolic complications and experience resistance or no effect after use of anticoagulants
• Patients resistant to conservative therapies and experience arrhythmias that lead to hemodynamic disturbances

Heart aneurysm procedures most often involve excision of the region followed by medical devices used to bulge the wall of the left ventricle or interventricular septum of the heart. Cardiac surgery techniques are minimally invasive and have a high frequency of successful ablation in treatment in Israel of arrhythmia. Arrhythmia, often accompanied by an aneurysm of the heart is treated on a strictly individual basis. Patients treated for heart aneurysm at Herzliya Medical Center are providing high-quality care throughout a thorough course of rehabilitation therapy and ongoing observation on an outpatient basis.