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Left ventricular pseudoaneurysm following acute myocardial infarction generally has an extremely poor prognosis without surgical repair. A rare case of long term survival for 23 years following cardiac rupture with subsequent development of a left ventricular pseudoaneurysm after acute myocardial infarction is reported. The patient suffered acute inferoposterior myocardial infarction in July 1974 at the age of 58 years. Clinical course and findings obtained on reassessment in 1992 (transesophageal echocardiography, chest computed tomography and left ventriculography) confirmed a left ventricular pseudoaneurysm. The patient refused surgical resection of the lesion, but remained alive and well in 1997 (81 years old). In this case, it is considered that containment of hemorrhage by pericardial adhesion prevented immediate tamponade and sudden death.
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