Left ventricular pseudoaneurysm. Its recognition and significance.

CARDIAC rupture is a major cause of mortality after myocardial infarction. 1,2 In a small percentage of patients, cardiac rupture is not a catastrophic event, but, rather, results in the formation of a pseudoaneurysm. Pseudoaneurysm is the result of ventricular rupture contained by adherent pericardium and fibrotic tissue. Pseudoaneurysm is thus characterized by the absence of myocardial tissue in its wall and a relatively narrow ostium between the ventricle and the paraventricular chamber (Fig 1). The plain-film finding of a paracardiac mass in a diaphragmatic or posterolateral location (Fig 2) in conjunction with a history of previous myocardial infarction is highly suggestive of pseudoaneurysm and is sufficient indication for angiographic studies. 3,4 Left ventriculography will show a paraventricular chamber filling via a relatively narrow ostium. The diagnosis is confirmed by demonstrating an avascular wall on coronary arteriography. 4 Report of a Case A 62-year-old man was admitted for syncope and