Giant left ventricular pseudoaneurysm following acute inferior wall myocardial infarction presenting with acute left ventricular failure: a rare complication.

To cite: Patra S, Dhadake SM, Agrawal N, et al. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2013200270 DESCRIPTION Left ventricular (LV) pseudoaneurysm is a rare but potentially lethal late mechanical complication of acute myocardial infarction (MI). We present a case of 50-year-old man who presented with acute inferior wall MI. He was treated with thrombolytic agent streptokinase. ECG showed ST elevation and Twave inversion in inferior leads (figure 1). Coronary angiogram on the next day showed significant stenosis in right coronary artery (figure 2; video 1). On the third day after MI, he developed a sudden onset of pulmonary oedema. Echocardiography showed rupture of posterolateral free wall of LV (figure 3; video 2). It also showed the formation of giant pseudoaneurysm with a diameter of 3 cm×7.1 cm (figure 4; video 3). Pseudoaneurysms are three times more often localised on the inferior and posterolateral wall, whereas true aneurysms in 80–90% of cases are located within the apical or on the anterolateral