An unnatural history of left ventricular pseudoaneurysm?

We report the case of a 79-year-old woman with a history of methicillin-resistant Staphylococcus aureus bacteremia and purulent pericarditis with subsequent subxiphoid pericardiostomy and formation of a large left ventricular pseudoaneurysm (LVPA) that has been medically managed. Long-term survival after pseudoaneurysm formation has traditionally been thought to be unusual without operative intervention. Computed tomography (CT), three-dimensional reconstructed CT, and echocardiographic images documenting the progression of the LVPA are presented over the course of the patient's follow-up. This case highlights the natural history of LVPA and the utility of multimodal imaging in allowing accurate assessment of LVPA anatomy.