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Jonathan Hinton, George Hunter, Madhava Dissanayake, and Rob Hatrick

Summary

Pseudo-aneurysms are a rare, potentially life-threatening complication of a myocardial infarction. We present the case of a 45-year-old male who was brought to the emergency department in extremis and had a previous history of a late presentation inferior ST-elevation myocardial infarction treated percutaneously. Clinical examination revealed evidence of cardiogenic shock, pulmonary edema and a pulsatile epigastric mass. Chest X-ray demonstrated marked cardiomegaly and pulmonary edema. Urgent echocardiography confirmed the presence of a huge basal inferior wall pseudo-aneurysm with bi-directional flow. This was also associated with severe mitral regurgitation, due to posterior mitral annular involvement. The patient was transferred to the local cardiothoracic surgical unit where he underwent emergency repair of the pseudo-aneurysm and mitral valve replacement. Despite the surgery being complex he made a full recovery.

Open access

Sathish Kumar Parasuraman PhD MRCP, Janaki Srinivasan, and Paul Broadhurst

( 11 ). It is remarkable that our patient could undergo several months of haemodialysis with left ventricular pseudo-aneurysm, without major haemodynamic compromise. We evaluated the risk of surgical vs percutaneous closure in our patient. With her