Abstract

Left ventricular pseudoaneurysm is a rare but life-threatening disorder that is frequently reported secondary to myocardial infarction or cardiac surgery. In this article, we chronicle the case of a patient with no prior risk factors who presented with a 2-week history of nonexertional atypical left chest pain. Apical 2-chamber transthoracic echocardiography revealed an unexpected outpouching of basal inferoseptal wall of the left ventricle, which had a narrow neck and relatively wide apex. The patient was diagnosed with left ventricular pseudoaneurysm and medical therapy was initiated. He refused to undergo the surgical intervention and subsequently, he was discharged from the hospital in stable condition. This article illustrates that physicians should be vigilant for atypical presentations of left ventricular pseudoaneurysm, and a high index of suspicion should be maintained for this stealth killer while performing appropriate diagnostic imaging. Additionally, we review the currently available approaches to diagnosis and management in these patients.

Highlights

  • Left ventricular pseudoaneurysm (LVP) is a rare but serious clinicopathologic entity

  • We present a case of basal inferoseptal LVP

  • Most of the LVPs develop after myocardial infarction (MI) or cardiothoracic surgery

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Summary

Introduction

Left ventricular pseudoaneurysm (LVP) is a rare but serious clinicopathologic entity. The clinical presentation can be nonspecific, including congestive heart failure, chest pain, dyspnea or arrhythmia leading to a delay in the diagnosis.[1] Several case reports show its occurrence secondary to myocardial infarction (MI), cardiac surgery and interventions, infection, or trauma.[1,2] This disease carries a significant risk of rupture due to a strong tendency to grow rapidly.

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