A case of a giant left ventricular pseudoaneurysm

A Left ventricular pseudoaneurysm is an outpouching resulting from myocardial free wall rupture which is contained by an adherent pericardium or scar tissue. It most often occurs after transmural myocardial infarction, but may also follow cardiac operations, trauma, inflammation, or infection. In contrast to patients with true ventricular aneurysms, those with false aneurysms most commonly die of hemorrhage. Transthoracic echocardiogram, computed tomography scan and cardiac MRI are currently the noninvasive modalities, whereas coronary arteriography and left ventriculography are invasive modalities used for diagnosis. As this condition is lethal, prompt diagnosis and timely management are vital. We present a case report of a patient with no prior risk factors who presented for 1 year with palpitations during exercise and rest, as well as intermittent chest pain. A transthoracic echocardiogram was performed. Echocardiogram revealed an unexpected outpouching of the left ventricle. A computed tomography scan confirmed the diagnosis by revealing a massive left ventricule pseudomanoeuvre. The patient was offered surgery, but he refused the procedure due to the surgical risk.