Right Ventricular Pseudoaneurysm in a Chronic Haemodialysis Patient: A Common Presentation of Shortness of Breath With a Rare Cause

A right ventricular pseudoaneurysm is a rare and serious complication secondary to central venous catheterisation and can present as subtle nonspecific cardiopulmonary symptoms. This case reports an 88-year-old woman on chronic haemodialysis via a right internal jugular tunnelled catheter which was described as a technically difficult insertion. Although initially asymptomatic, three months later, the patient developed orthopnoea and progressive dyspnoea with an incidental new onset of atrial fibrillation. Transthoracic echocardiography and computed tomography demonstrated a right ventricular pseudoaneurysm with an associated pericardial effusion and pulmonary emboli. At the time of admission, whilst the patient's diagnosis was being established, she became haemodynamically unstable. Surgical management and haemodialysis then became unfeasible, which led to the patient's demise during hospitalisation. This case highlights the importance of early imaging and a high clinical suspicion, given the high mortality rates associated with a right ventricular pseudoaneurysm.