Best Cases: Ischemic Heart Disease-A Rare Concomitant Left Ventricular Aneurysm and Pseudo Aneurysm Following Acute Myocardial Infarction: Role of Cardiac Magnetic Resonance Imaging

A Rare Concomitant Left Ventricular Aneurysm and Pseudo Aneurysm Following Acute Myocardial Infarction: Role of Cardiac Magnetic Resonance Imaging

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Video Summary

A 66-year-old man with CAD and nonadherence to dual antiplatelet therapy presented with acute chest pain, decompensated heart failure, and severe multivessel disease after MI. Cath and echocardiography suggested an LV outpouching, but cardiac MRI clarified the diagnosis: a large basal inferior LV pseudaneurysm with substantial thrombus plus a separate apical true aneurysm. MRI also showed infarction in the inferior and lateral walls. He was not a surgical candidate due to high risk and comorbidities. The case highlights that CMR can detect thrombus and distinguish true aneurysm from pseudaneurysm better than echocardiography.

Keywords

left ventricular pseudaneurysm

true ventricular aneurysm

cardiac MRI

left ventricular thrombus

myocardial infarction