Pseudoaneurysm of the left ventricle. Radiographic and angiocardiographic diagnosis.
Left ventricular pseudoaneurysms represent intrapericardial ruptures contained by adherent pericardium and fibrous tissue, forming an avascular wall; in contrast, the wall of a true aneurysm is formed of fibrous elements of the infarcted myocardium and contains coronary vessels. Prior myocardial infarction and/or aneurysmectomy may predispose to pseudoaneurysm formation. Plain radiographs, echocardiography, gated cardiac blood pool imaging, and left ventriculography are helpful, and the combination of left ventriculography and selective coronary arteriography is diagnostic. A uni- or multiloculated chamber communicating with the left ventricle by a relatively small orifice without draping of coronary vessels is diagnostic of pseudoaneurysm.