Six-year follow-up of a left ventricular pseudoaneurysm without surgical repair.

Pseudoaneurysm of the left ventricle is a rare complication of acute myocardial infarction. The present report describes the unusual case of a 75-year-old woman who survived six years with an unrepaired left ventricular pseudoaneurysm. The diagnosis of pseudoaneurysm was made after two-dimensional echocardiography showed an extra large chamber next to the posterolateral region of the left ventricle with a massive thrombus; the diagnosis was confirmed by magnetic resonance imaging four years later. The patient refused surgical repair and continued with acetylsalicylic acid, a beta-blocker and an angiotensin II receptor antagonist. The patient was essentially asymptomatic and followed at six-month intervals until she died of carcinoma of the urinary bladder in the sixth year. The present case indicates that surgery is not the only therapeutic option in patients with a ventricular pseudoaneurysm.