Clinical Summary
A 52-year-old woman presented in out-patient clinic for the follow-up of a left ventricular thrombus after an anterior myocardial infarction due to chronic occlusion of distal left anterior descending artery three months earlier. She was treated conservatively and myocardial viability diagnostics were planned. Transthoracic echocardiography revealed a moderate left ventricular function and a free wall rupture contained by an apical pseudoaneurysm (Figure 1A, asterisk). Computed tomography of the heart confirmed the presence of a partially thrombosed left ventricular pseudoaneurysm (Figure 1B, asterisk). The patient underwent cardiac surgery. After the resection of the aneurysm (Figure 1C), endoventricular patch plasty (Dor) technique was applied for exclusion of the rupture with a double patch (Figure 1D). The patient recovered fully and remained asymptomatic. Follow-up echocardiography (Figure 1E) and magnetic resonance imaging (Figure 1F) showed a good left ventricular function without intracardiac thrombus and excluded apical pseudoaneurysm (Figure 1E and 1F, arroheads).