Left Ventricular False Aneurysm

Left ventricular false aneurysm, also known as pseudoaneurysm, is a rare and highly morbid pathology. It most commonly presents as a complication of myocardial infarction (MI). It occurs when an ischemic left ventricular free wall rupture (due to acute infarction) is contained as a hematoma communicating with the ventricular cavity. The rupture could become sealed by an adherent pericardium, organizing hematoma, thrombus, or scar tissue and gives the appearance of an aneurysm. The wall of the false aneurysm consists only of fibrous tissue or pericardium and lacks the true layers of the ventricle (endocardium and myocardium). False aneurysms tend to appear on the posterior and lateral wall segments and demonstrate a tightened neck compared to the aneurysm sac diameter. These aneurysms have a higher propensity to rupture and necessitate timely diagnosis and management.