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Case report
Unusual presentation of left ventricular rupture
  1. Amarbir S Bhullar1,
  2. Charnjeet Singh Sandhu2,
  3. Manminder S Bhullar1 and
  4. Ankit Rathod1
  1. 1Cardiology, University of California San Francisco, Fresno, California, USA
  2. 2Internal Medicine, University of California San Francisco, Fresno, California, USA
  1. Correspondence to Dr Charnjeet Singh Sandhu; CSandhu{at}


We describe a case of 49-year-old man who presented with chest pain and was diagnosed with non-ST elevation myocardial infarction. Transthoracic echocardiogram (TTE) showed severe global hypokinesis of left ventricle with ejection fraction of 25%–30%. Left heart catheterisation showed severe right coronary stenosis and focal 60%–70% distal left anterior descending artery stenosis. Cardiac MRI (CMR) was done for evaluation of viability which showed a large pseudoaneurysm which was missed on TTE and left ventriculogram. Our case demonstrates the increasing importance of cardiac MRI in the diagnosis of left ventricular pseudoaneurysm. In our case left ventricular pseudoaneurysm was missed on TTE and left ventriculogram. It was diagnosed on CMR which was ordered for evaluation of myocardium viability.

  • heart failure
  • ischaemic heart disease
  • clinical diagnostic tests
  • radiology (diagnostics)

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  • Contributors ASB, CSS and AR were involved in patient care. AR read cardiac MRI. CSS, ASB, AR and MSB were involved in drafting manuscript. All authors read and approved the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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