[False aneurysms extending from true aneurysms of the left ventricle]

Over a 10 year period, four cases of post myocardial infarction pseudo-left ventricular aneurysm were observed, two directly arising from the infarct (postero diaphragmatic patients had pseudo-aneurysms which arose inferiorly from true anteroapical aneurysms and underwent surgical resection. Apart from the histological features, a certain number of diagnostic signs merit review: --A clinical course marked by a number of phases (myocardial infarction--pericardial syndrome--true aneurysm complicated or not by arrhythmias--period of stabilisation followed by deterioration due to rapid progression of cardiac failure). -- "Angiographic-like" ultrasonic and isotopic methods complement left ventriculography which confirms the parietal aneurysm and may show three very suggestive signs of pseudo-aneurysm: a narrow communication with the true aneurysm; delayed and prolonged filling of the bulge; inferior extension with localization by pericardial adhesions. Surgery is imperative, the main problem being the extent of resection of the true aneurysm. This is related to the rigid or calcific character of the neck of the pseudo-aneurysm.