False inferior pseudoaneurysm: two-dimensional and Doppler echocardiographic findings

The noninvasive differentiation of true aneurysm from pseudoaneurysm is sensitively and specifically accomplished with two-dimensional echocardiography. Recent reports suggest that Doppler flow patterns may further enhance the specificity of the diagnosis of pseudoaneurysm. We present a patient with ventriculographic and two-dimensional echocardiographic features of an inferior pseudoaneurysm. Doppler examination, however, failed to show phasic flow characteristic of a small communicating orifice between two larger chambers. At surgery, a large posterolateral true aneurysm was found. Thus the addition of Doppler flow patterns to imaging information may help to distinguish pseudoaneurysms from true aneurysms.