Case Author(s): Michael Roarke, M.D. and Jerold Wallis, M.D. , 2/12/96. Rating: #D2, #Q5

Diagnosis: Left ventricular pseudoaneurysm

Brief history:

66-year old woman with history of cardiac disease who presents with worsening congestive heart failure.


End diastole (top) and end systole (bottom)

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View second image(ct). Axial image from contrast-enhanced CT of the chest

Full history/Diagnosis is available below

Diagnosis: Left ventricular pseudoaneurysm

Full history:

66-year old woman with history of past myocardial infarction who presents with worsening congestive heart failure.


Tc-99m in vitro labeled red cells


Cardiac blood pool images obtained at rest reveal an area of focal blood pool activity posterior and lateral to the left ventricle. It appears slightly more prominent on the end systolic images than the end diastolic images. The computed tomography images reveal a left ventricular pseudoaneurysm corresponding to this area of abnormal blood pool activity.


While true left ventricular aneurysms represent dilatation of the myocardium focally, usually in areas of previous infarction, left ventricular pseudoaneurysms result from a focal rupture of the myocardium, with the blood pool contained by the overlying pericardium. The posterolateral location of this pseudoaneurysm is characteristic.

Differential Diagnosis List

In addition to left ventricular pseudoaneurysm, an alternate possibility is aneurysm of the descending thoracic aorta. The computed tomographic findings help to differentiate between these possibilities.

ACR Codes and Keywords:

References and General Discussion of Cardiac Blood Pool Scintigraphy (Anatomic field:Heart and Great Vessels, Category:Misc)

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Case number: ca002

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