Two and one half years after a lateral wall myocardial infarction, this 75-year-old patient was found to have marked cardiomegaly on chest radiograph. He had no cardiac symptoms. Chest CT with contrast (Fig 1⇓) revealed a giant (23×13 cm) pseudoaneurysm (PAN), partially filled with clot (C), communicating with the left ventricle (LV). Echocardiography (apical view, Fig 2⇓) further demonstrated the size of the hole (2.5 cm) in the LV lateral wall (arrow). Color Doppler (Fig 3⇓) demonstrated systolic blood flow from the LV into the pseudoaneurysm (Fig 3A) and diastolic blood flow from the pseudoaneurysm into the LV in diastole (Fig 3B). RV indicates right ventricle; LA, left atrium; and RA, right atrium.
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine. Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke's Episcopal Hospital and Texas Heart Institute, 6720 Bertner, MC 4-265, Houston, TX 77030.
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