Why the study?
Cardiac pseudoaneurysm is rare and its apical localization is scarce, as it is typically described in the posterior or lateral wall of the left ventricle.
This case highlights the role of multimodality imaging, particularly CMRI, in diagnosing rare apical left ventricular pseudoaneurysms following myocardial infarction.
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May prompt CMR for post-MI apical murmur and HF; leaves open medical versus surgical care of unruptured cases.
Cardiac pseudoaneurysm is rare and appears mostly as tardive complication of Acute Myocardial Infarct (AMI). Its apical localization is also scarce as it is usually described in posterior or lateral wall of left ventricle. Its diagnosis is based on cardiac imaging. We report a case of a hypertensive, diabetic and smoking 64-year-old man with a past history of anterior AMI. He was symptomatic of chest discomfort. Physical examination indicates an apical murmur, his electrocardiogram showed a regular sinus rhythm and a complete left branch block. The Transthoracic (TTE) echocardiography revealed a giant apical pocketlike aneurysm lined with a clot. Cardiac Magnetic Resonance Imaging (CMRI) confirmed the diagnosis of an apical pseudoaneurysm due to ischemic heart disease in the stage of severe heart failure.
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Rekik et al. (2021) studied this question.
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