Rare Presentation of Pseudoaneurysm Obstructing the Left Ventricular Inflow Tract in a Patient With Acute Myocardial Infarction

Introduction

Left ventricular (LV) pseudoaneurysm is nowadays a rare but still potentially fatal complication of myocardial infarction (MI). Recent studies have estimated that following ST-elevation MI, 0.27 to 0.91% of patients develop mechanical complications. LV free wall rupture (VFWR) is estimated to occur in 0.01 to 0.52% of patients, showing a clear decrease in incidence associated with the widespread adoption of reperfusion therapy. Nonetheless, there has been no significant decrease in associated mortality rates and this complication remains an important determinant of outcomes after MI.

A pseudoaneurysm is formed when a cardiac rupture is contained by adherent pericardium or scar tissue, with no myocardial tissue. Transmural MI is the most common cause, usually following occlusion of the right coronary artery or the circumflex artery, therefore more often occurring on the posterior or lateral wall.

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