A40-year-old male smoker without any other discernible risk factors for coronary artery disease presented with complaints of progressively increasing shortness of breath and swelling of bilateral feet for the past 3 months. He did not have any history suggestive of acute coronary syndrome. Two-dimensional echocardiography revealed a large thick-walled cavity with a narrow base attached to the left ventricular apex suggestive of a pseudoaneurysm (PSA) [Figures 1 and 2]. The PSA cavity was layered with thrombus [Figures 3 and 4] Figure 1 showed to-and-fro blood flow into it.
Figure 1.
Apical four chamber view showing to-and-fro blood flow into the pseudoaneurysm cavity
Figure 2.
Modified parasternal long-axis view showing a large pseudoaneurysm with layered thrombus contained by pericardium
Figure 3.
Modified parasternal long-axis view showing thick-walled pseudoaneurysm cavity with layered thrombus
Figure 4.
Computed tomography scan coronal view showing large pseudoaneurysm at the apex of the left ventricle contained by layered thrombus and pericardium
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