Ventricular aneurysm—true or pseudo—is a potential complication of transmural myocardial infarction; the establishment of a patent infarct artery reduces the risk of aneurysm formation.1,2  Ventricular aneurysm may be seen in other conditions such as hypertrophic cardiomyopathy, cardiac sarcoidosis, myocarditis, congenital disease, after cardiac surgery, and in blunt trauma.3–8 

A true ventricular aneurysm differs from a pseudoaneurysm in terms of morphology and risk of rupture. A true ventricular aneurysm is thinning of the ventricular wall in an area void of muscle and is caused by fibrosis or scar formation; it is akinetic and bulges during systole and diastole (Figure 1a). A true aneurysm has a wide neck, and the original wall of the myocardium is present within the aneurysmal wall.1,9 

A pseudoaneurysm has a narrow neck and involves a rupture of the...

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