Left ventricular pseudoaneurysm (LVPA) is associated with a significant mortality rate of up to 45% in the first year after diagnosis. It is audvery rare entity and hence the true incidence and natural history are not clearly known. Clinical presentation varies widely and requires audhigh index of suspicion for diagnosis. We report the case of a 72-year-old woman with a remote history of left ventricular aneurysm repairudduring coronary bypass surgery who presented to the emergency department with acute onset of left-sided chest pain and a pulsatile chestudwall swelling. She was haemodynamically stable but required an intravenous morphine drip for pain control. Contrast-enhanced computedudtomography of the chest showed a large LVPA dissecting through the anterior chest wall. Surgical treatment was discussed with the patientudbut she opted in favour of comfort care. She died 5 days later from complete rupture of the LVPA. With this report, we aim to raise theudlevel of awareness of LVPA that could anatomically expand and rupture. Early diagnosis and timely surgical intervention is the treatmentudof choice.
展开▼
