Left ventricular pseudotumor: a two-dimensional echocardiographic sign of aortic insufficiency

A left ventricular, mass-like echocardiographic density (a pseudotumor), present only during diastole and not attached to any intracardiac structure, was present in 77 of 1,820 consecutive 2-dimensional echocardiograms performed with a rotating-head transducer. Evaluation of the patients with a pseudotumor demonstrated that aortic insufficiency of mild to moderate degree was the most commonly associated lesion. Of the 61 patients with aortic insufficiency in our series, 69% had a left ventricular pseudotumor. Of the cases with a pseudotumor and aortic insufficiency, none had severe aortic insufficiency. Of the 1,759 patients without aortic insufficiency, a left ventricular pseudotumor was present in 2%. In our series, the sensitivity of left ventricular pseudotumor for aortic insufficiency was 69% and the specificity was 98%.