Giant Left Ventricular Pseudoaneurysm in a 79-Year-Old Female Patient: Diagnostic and Management

Nina Solomakhina, Alexey Lishuta, Ekaterina Gladysheva, Anna Dementeva


Left ventricular pseudoaneurysm is a rare but dangerous complication, which occurs in the early post myocardial infarction period. Small pseudoaneurysms are not fatal, while large ones cause death due to sudden rupture and cardiac tamponade if surgery is not performed on time. As left ventricular pseudoaneurysm is uncommon in population, only few case reports were found in the published literature. In this article, we present a case of left ventricular pseudoaneurysm in a 79-year-old female patient after a silent posterolateral myocardial infarction, which increased to gigantic size for 3 months and was diagnosed accidentally by transthoracic echocardiography. Since the patient refused surgical treatment, the difficulties in deciding on the management of the patient based on a review of the literature is described. The main goal of this case is to describe the 6-month survival rate of a 79-year-old female patient with left ventricular pseudoaneurysm after silent posterolateral myocardial infarction despite refusal of surgical treatment and extremely low adherence to drug treatment due to cognitive impairment.


left ventricular pseudoaneurysm; echocardiography; diagnosis; prognosis


Varvarigos N, Koletsis E, Zafiropoulos A, et al. A case of left ventricular pseudoaneurysm with long survival and congestive heart failure as first presentation. Case report and review of the literature. Med Sci Monit. 2005;11(11):69-73. PMID: 16258404.

Roa-Castro VH, Molina-Bello E, Valenzuela-Suárez H, et al. Survival after left ventricular free wall rupture in an elderly woman with acute myocardial infarction treated only medically. Case Rep Vasc Med. 2012;2012:728602. DOI:10.1155/2012/728602.

Helmy TA, Nicholson WJ, Lick S, et al Contained myocardial rupture: a variant linking complete and incomplete rupture Heart. 2005;91:e13. DOI:10.1136/hrt.2004.048082.

Davies MJ. Ischaemic ventricular aneurysms: True or false? Heart. 1988;60(2):95-97. DOI: 10.1136 / hrt.60.2.95

Rudakova LE, Rakhmatullov FK, Bondarenko LA, Fatkabrarov MF, Fatkabrarova AM. Retrospective analysis of myocardial rupture cases in patients with acute myocardial infarction. Russian J Cardiol. 2010;(4):10-14 (In Russ.). DOI:10.15829/1560-4071-2010-4.

Hoey DR, Kravitz J, Vanderbeek PB, et al. Left ventricular pseudoaneurysm causing myocardial infarction and cerebrovascular accident. J Emerg Med. 2005;28(4):431-5. DOI:10.1016/j.jemermed.2004.12.013.

Frances C, Romero A, Grady D. Left ventricular pseudoaneurysm. Am Coll Cardiol. 1998;32(3):557-561. DOI:10.1016/S0735-1097 (98)00290-3.

Eren E, Bozbuga N, Toker ME, et al. Surgical treatment of post-infarction left ventricular pseudoaneurysm. A two-decade experience. Texas Heart Inst J. 2007;34(1):47-51. PMID: 17420793.

Kadin R, Fellat N, Doghmi N, et al. Giant left ventricular false aneurysme revealing a silent myocardial infarction. Ann Cardiol Angeiol (Paris). 2020;69(3):144-7 (In French). DOI:10.1016/j.ancard.2019.08.014.

Yeo TC, Malouf JF, Oh JK, et al. Clinical profile and outcome in 52 patients with cardiac pseudoaneurysm. Annals Internal Medicine. 1998;128(4):299. DOI:10.7326 / 0003-4819-128-4-199802150-00010.

Moreno R, Gordillo E, Zamorano J, et al. Long term outcome of patients with postinfarction left ventricular pseudoaneurysm. Heart. 2003;89(10):1144-1146. DOI:10.1136/heart.89.10.1144.

Sheikh WR, Sehgal P, Verma A, et al. Left ventricular pseudoaneurysm post myocardial infarction Int J Crit Illn Inj Sci. 2019;9(1):43-45. DOI:10.4103/IJCIIS.IJCIIS_42_18.

Hulten EA, Blankstein R. Pseudoaneurysms of the heart. Circulation. 2012;125(15):1920-1925. DOI:10.1161/CIRCULATIONAHA.111.043984.

Zeltyn-Abramov EM, Radzevich AE. External cardiac breaks in the acute period of myocardial infarction: clinical and instrumental predictors. Russian Journal of Cardiology. 2010;2(82):10-13 (In Russ.). DOI:10.15829/1560-4071-2010-2.

Alapati L, Chitwood WR, Cahill J, et al. Left ventricular pseudoaneurysm: A case report and review of the literature. World J Clin Cases. 2014;2(4):90-93. DOI:10.12998/wjcc.v2.i4.90.

Contuzzi R, Gatto L, Patti G, et al. Giant left ventricular pseudoaneurysm complicating an acute myocardial infarction in patient with previous cardiac surgery: a case report Journal of Cardiovascular Medicine. 2009;10(1):81-4. DOI:10.2459/JCM.0b013e32831a98e6.

Katkova LA, Furman NV, Dolotovskaya PV, et al. Chronic heart failure due to the formation of a giant pseudoaneurysm of the left ventricle after a painless myocardial infarction in a patient with type 2 diabetes. Kardiologiia. 2016;56(9):92-6 (In Russ.). DOI:10.18565/cardio.2016.9.92-96.

Díaz-Navarro R, Nihoyannopoulos P. Post-myocardial infarction left ventricular pseudoaneurysm diagnosed incidentally by echocardiography. Echo Res Pract. 2017;4(4):K37-K40. DOI:10.1530/ERP-17-0035.

Full Text: PDF


  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.