Patient History

A 67 year old male presents to the ER with complaints of chest pain.

• EKG showed ST segment elevation in V5/V6

Echo Findings

Apical 2 Echo Pseudoaneurysm

Answer: LV Inferior Pseudoaneurysm

Pseudoaneruysms of the left ventricle is a rare complication that results after a myocardial infarction (MI). These aneurysms are localized and contained within the pericardium. Those who are at higher risk for pseudoaneurysms include:

• Older population
• Females
• Hypertension
• Involve a inferior or lateral wall MI

Echo Findings:

• They present with a thin/narrow neck that bulges from the ventricular cavity.
• The segmental wall motion will display either dyskinetic or akinetic, in comparison to the rest of the ventricular myocardium.
• Pseudoaneurysms can be challenging to diagnosis on TTE and may require other modalities to confirm.

Complications:

• Pseudoaneurysms have a high mortality rate without surgical intervention.
• Delayed surgical intervention can increase risk of rupture.
• The stasis blood within the aneuruysm can cause risk for thrombosis and embolic event.