An Asymptomatic Left Ventricular Pseudoaneurysm found incidentally at 12 months post Myocardial Infarction: Case Report and Review of the Literature


  • Christian Brooks John Hunter Hospital Lookout Road New Lambton Heights NSW 2305 Australia
  • Heather Cooke John Hunter Hospital Lookout Road New Lambton Heights NSW 2305 Australia



Cardiac catheterisation, Echocardiography, Left Ventricular Pseudoaneurysm, Myocardial Infarction.



Left ventricular pseudoaneurysms are a rare mechanical complication of myocardial infarction. If found acutely following infarction (within 2 weeks, with some advocating up to 3 months), surgical repair is recommended due to their high risk of rupture.

Whilst associated with chest pain, dyspnoea and heart failure, some individuals are asymptomatic, with the diagnosis made incidentally on routine follow-up often months to years post infarction. Less is known about the natural history of these chronic pseudoaneurysms, with concerns around their propensity to rupture perhaps less than the mortality risk of surgical repair.

We present the case of a 70 year-old asymptomatic man who was found to have a 1.6cm left ventricular pseudoaneurysm found incidentally on routine transthoracic echocardiogram at 12-months post posterior myocardial infarction.

The consensus opinion of our institution's multi-disciplinary team regarding further management of this patient, with reference to the current limited data on chronic pseudoaneurysms, will be discussed.

Author Biographies

Christian Brooks, John Hunter Hospital Lookout Road New Lambton Heights NSW 2305 Australia

Dr Brooks has just successfully completed the Royal Australian College of Physicians' Basic Physician Training programme. From 2020 onwards, he will be working within the Hunter New England Local Health District in New South Wales, Australia, as an Advanced Physician Trainee in General Medicine.

Throughout his training to-date, Dr Brooks has always enjoyed cardiology terms and has encountered several interesting cases. He is keen to contribute to the literature and to learn more about cardiology, and following completion of General Medicine Advanced Training, plans to dual-train and undertake a dedicated Cardiology Advanced Training program.

Heather Cooke, John Hunter Hospital Lookout Road New Lambton Heights NSW 2305 Australia

Dr Heather Cooke is a staff specialist cardiologist at the John Hunter Hospital, New Lambton Heights, NSW, Australia. Dr Cooke is a registered specialist with the FRACP and a member of both the American and Canadian Societies of Echocardiography.After completing her general cardiology training in Queensland she undertook the first of two fellowships in cardiac imaging at the prestigious Peter Munk Cardiac Centre in Toronto, Canada.Furthering her interest in cardiac imaging, and particularly the role of imaging in coronary artery disease, Dr Cooke undertook a second fellowship in Nuclear cardiology, also in Toronto Canada. 


Van Tassel RA, Edwards JE. Rupture of heart complicating myocardial infarction. Analysis of 40 cases including nine examples of left ventricular false aneurysm. Chest. 1972 Feb;61(2):104-16. DOI: 10.1378/chest.61.2.104

Frances C, Romero A, Grady D. Left ventricular pseudoaneurysm. J Am Coll Cardiol 1998; 32(3): 557-61. 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. Tex Heart Inst J 2007; 34(1): 47-51. URL:

Moreno R, Gordillo E, Zamorano J, Almeria C, Garcia-Rubira JC, Fernandez-Ortiz A, et al. Long term outcome of patients with postinfarction left ventricular pseudoaneurysm. Heart. 2003 Oct;89(10):1144-6. DOI: 10.1136/heart.89.10.1144

Arslantas U, Kilicgedik A, Cersit S, Acar RD, Pala S. A fifteen years old left ventricular pseudoaneurysm. Int J Cardiol. 2016 Jan 15;203:527-8. DOI: 10.1016/j.ijcard.2015.10.192

Csapo K, Voith L, Szuk T, Edes I, Kereiakes DJ. Postinfarction left ventricular pseudoaneurysm. Clin Cardiol 1997; 20(10): 898-903. DOI: 10.1002/clc.4960201021

Dachman AH, Spindola-Franco H, Solomon N. Left ventricular pseudoaneurysm. Its recognition and significance. Jama. 1981 Oct 23-30;246(17):1951-3. DOI: 10.1001/jama.1981.03320170063036

Rittenhouse EA, Sauvage LR, Mansfield PB, Smith JC, Davis CC, Hall DG. False aneurysm of the left ventricle. Report of four cases and review of surgical management. Ann Surg. 1979 Apr;189(4):409-15. URL:

Otto CM. Ischemic cardiac disease. In: Otto CM, editor. Textbook of clinical echocardiography. 5th ed. Philadelphia: Elsevier Saunders; 2013. p. 209–216.

Pretre R, Linka A, Jenni R, Turina MI. Surgical treatment of acquired left ventricular pseudoaneurysms. Ann Thorac Surg 2000; 70(2): 553-7. DOI: 10.1016/S0003-4975(00)01412-0

Shewan LG, Coats AJS, Henein MY. Authors’ Responsibilities and Ethical Publishing. International Cardiovascular Forum Journal 2018;13:3-4, DOI: 10.17987/icfj.v13i0.525.






Letters to the Editor