The patient's chest X-ray showed enlargement of the apical cardiac silhouette (Figure 1A). Transthoracic echocardiography (TTE) revealed a regional wall motion abnormalities at the left ventricular (LV) apex with a large apical pseudoaneurysm 60×36 mm in size. The pseudoaneurysm was filled with the systolic and diastolic blood flow and its lumen was connected to the LV cavity through a neck (Figure 1D and E, Supplementary Videos 1, 2, 3). Three-dimensional echocardiography well demonstrated 14×10-mm orifice of the pseudoaneurysm in detail (Figure 1F, Supplementary Video 4). A computed tomography (CT) angiography performed for further evaluation confirmed the presence of the pseudoaneurysm and its connection to the LV cavity through a neck (Figure 1B and C, Supplementary Video 5). We offered the treatment options but the patient refused to undergo interventions.

Pseudoaneurysm of the LV is a rare but lethal complication of myocardial infarction,cardiothoracic surgery, and trauma. Because the development of a tamponade after LV rupture is usually fatal. Surgical or percutaneous interventions are primarily preferred for the management of LV pseudoaneurysms. The advances in imaging methods and consequent improvements in the detection of LV pseudoaneurysms have allowed to follow-up asymptomatic patients with medical therapy.

In this case presentation,we presented the development of a non-cardiac surgery-related pseudoaneurysm of LV; which was well-visualized with echocardiography and CT.