Pseudoaneurisma gigante del ventriculo izquierdo

A 85 years old patient was hospitalized because of thoracic pain, lasting since three months. He suffered of Parkinson's disease and he was a smoker. The pain increased with cough and Vansalva's test. His left arm was cianotic. An arterial obstruction was suspected. Dopler ultrasound of the left arm confirmed a partial obstruction of the left axillar artery. Surprisingly, thoracic scan and MRI found an important cardiomegaly. The heart was in contact with the diaphragmatic and gastric region. Ecocardiography confirmed a 7 cm pseudo aneurysm of the left ventricle. Coronarography showed extreme hypokinesia of the left ventricle. There was also an obstruction of the right coronary and 50 % stenosis of the left coronary. Pseudo aneurysm was a complication of myocardial infarction of the left ventricle. Surgery was offered to the patient, but he declined the intervention. He was dismissed with medical treatment and anticoagulation. The patient deceased three months later.