M.-mode and two-dimensional echocardiographic diagnosis of pseudoaneurysm of the left ventricle (author's transl)

The echocardiographic features of a case of postinfarction pseudoaneurysm of the left ventricle are described. M-mode echocardiography displayed an echo-free space behind the posterior left ventricular wall and two-dimensional echocardiography defined the saccular contour of the pseudoaneurysm and its probable communication with the ventricular cavity. A second echocardiographic examination--a week later--revealed a marked enlargement of the pseudoaneurysm and a characteristic fast backward early systolic motion of the ventricular wall interposed between left ventricular cavity and the saccular aneurysm; this motion is interpreted as a passive displacement of the ruptured wall during ventricular systole, and allows a differential diagnosis with similar echocardiographic M-mode aspects, due to pericardial effusion, pleural effusion or pericardial cysts. Echocardiography findings were confirmed by angiocardiography and the surgery. Echocardiography seems to be a safe method for early non-invasive diagnosis of left ventricular pseudoaneurysm.