An Atypical Left Ventricular Pseudoaneurysm Managed Conservatively

Left ventricle (LV) pseudoaneurysms pose a serious and life-threatening complication of myocardial infarction. We present a case of a thrombosed LV pseudoaneurysm with clot extension into the LV cavity in an asymptomatic 62-year-old man presenting with nonsecific symptoms. Multimodal imaging was undertaken to confirm the diagnosis. Owing to the chronicity of the pseudoaneurysm, the patient was managed conservatively. This case illustrates an alternative management approach in a clinical scenario with a paucity of data and no clear guidelines. Multimodal imaging is critical to distinguish LV pseudoaneurysms from true aneurysms, particularly in atypical locations, as accurate diagnosis directly affects management decisions. Although surgical repair remains the standard treatment for LV pseudoaneurysms, select chronic cases may be candidates for conservative management. Long-term follow-up data is needed to validate this approach.