An unusual left ventricle pseudo-aneurysm with progressive mitral regurgitation

A 31-year-old man presented to our institute with complaints of intermittent precordial pain for several days. The patient denied risk factors for coronary artery disease and had no history of any trauma. Transthoracic echocardiography (TTE) showed a pseudo-aneurysm (30 mm × 40 mm) through a neck connected to basal inferolateral wall of the left ventricle (LV) (Panels A and B, stars) with no wall motion abnormalities. Mildly enlarged LV with mild mitral regurgitation (MR) was also detected (Panel B). White blood cell count was elevated (10.27 × 109/L). Serum Immunologic examinations were normal. Nothing special was found on the physical examination. Elective surgery was recommended, but he refused. He was stable and there were no significant changes of TTE on 6-month and 1-year follow-up. On 2-year follow-up, he admitted with dyspnoea. Transthoracic echocardiography revealed LV and left atrium were enlarged significantly with severe MR...