Medical Management of a Case of Inferior-Posterior Wall ST Elevation Myocardial Infarction Complicated by Pseudoaneurysm

Left ventricular pseudoaneurysm is a rare complication associated with high morbidity and mortality when symptomatic and is usually managed aggressively to prevent or reduce risk of mortality. Herein, we present the case of a 73-year-old man who underwent coronary artery bypass grafting 10 years ago, now presenting with an inferior-posterior wall myocardial infarction complicated by pseudoaneurysm. This case highlights the need for individual clinical assessment of patient presentation with consideration for medical management in acute settings in patients with pseudoaneurysm of the left ventricle. Despite the natural history of rare complications with pseudoaneurysms such as rupture and potentially fatal cardiac tamponade, infections, and arrhythmias, it is important to note that pseudoaneurysms can present with coronary artery disease and congestive heart failure, and clinicians need to have an index of suspicion for pseudoaneurysms despite advancement in medical and interventional management of coronary artery disease.