Large inferoposterior wall pseudoaneurysm - of the left ventricle with a thrombus after myocardial infarction

A 70-year-old man was admitted to our coronary care unit with severe dyspnea, nonproductive cough, and palpitations 1 month after an inferoposterolateral myocardial infarction. Two-dimensional echocardiography demonstrated severe left ventricular dysfunction and a large (6.6 x 7.9 cm) inferoposterior wall pseudoaneurysm of the left ventricle with a thrombus (Fig, 1). Electrocardiography showed QS formation in leads II, III, aVF, and V-5,V-6; Rs in V-1; and sustained ventricular tachycardia (Fig. 2). The patient refused such interventions as coronary angiography and surgery. His symptoms of heart failure and arrhythmia were relieved by medical therapy He was discharged from the hospital ar his request, and his wife found him dead in his bed 3 weeks later.