Presentation
History of ST-elevation myocardial infarction complicated with ventricular septal defect/rupture, and treated surgically. Presents with chest pain.
Patient Data
Large outpouching arising from the mid inferior left ventricular wall with a narrow neck.
No intramural thrombus. No fat stranding adjacent to this pseudo-aneurysm.
No hemopericardium. No active contrast extravasation of contrast.
No pulmonary embolism.
Mild regular interlobular septal thickening in keeping with pulmonary edema probably due to impaired cardiac output.
Sternotomy sequelae. Status post ventricular septal perforation repair.
Case Discussion
The differential diagnosis for this case is a left ventricular aneurysm. Unlike pseudo-aneurysms, a true aneurysm contains all the layers (endocardium, myocardium, and epicardium) and usually has a broad neck.