Dissecting the difference: Left ventricular aneurysm versus pseudoaneurysm

Left ventricular aneurysms (LVAs) and pseudoaneurysms (LVPs) are common complications following acute myocardial infarction (AMI), predominantly involving the anterior wall due to complete occlusion of the left anterior descending (LAD) artery. Both conditions are associated with heart failure, arrhythmias, and thromboembolic events. However, differentiating between LVA and LVP is crucial, as LVPs carry a higher rupture risk and require surgical management. We present a case of LVP, diagnosed using cardiac magnetic resonance imaging (CMRI), in a patient with chronic total occlusion of the LAD, which was managed surgically. This case emphasizes the critical role of imaging in guiding appropriate treatment decisions.