A 73-year-old woman presented with severe chest pain of 15 hours’ duration. Emergent coronary angiography showed occlusion of the mideleft anterior descending artery, which was successfully treated with a bare-metal stent. On day 6 after admission, she experienced a grade 4 systolic murmur at the left sternal border, associated with the development of a large pulsatile mass at the left anterior chest wall (Video 1, view video online). A transthoracic echocardiogram revealed a large cystic mass anterior to the right ventricular outflow tract (Fig. 1A; Video 2, view video online). Pulsed wave and colour Doppler demonstrated “to and fro” flow typical of left ventricular pseudoaneurysm (LVPA) (Fig. 1, B and C; Video 3, view video online). The site of rupture was shown by 3-dimensional (3D) transthoracic echocardiography to be at the mid to apical segment of the anterior wall of the left ventricle. It was circular and about 0.4 cm (Fig. 1, E and F; Videos 4 and 5, view video online). Injection of contrast medium (Definity, Lantheus Medical Imaging,