Introduction
LV aneurysms is usually defined as a well-delineated, thin, scarred, or
fibrotic wall devoid of muscle or containing necrotic muscle, caused by
healed transmural myocardial infarction (MI)[1],
thrombus is a serious complication of aneurysm, appropriate
antithrombotic therapy can reduced the incidence of thromboembolism and
mortality of patients with thromed LV
aneurysms[2]. Intra-myocardial dissection hematoma
(IDH) is an extremely rare and unusual form of impending heart rupture,
with the character of neocavitation in myocardium layer caused by blood
infiltrating among the myocardial fibers[3], which
may contribute to ventricular rupture. Due to the high mortality of IDH,
Surgery is recommoned if needed. Becaused of the serious complications
and different threatment for these two diseases, an early
differential diagnosis plays a vital role in
developing treatment. In theory, differential diagnosis of thrombosed LV
aneurysm and IDH is easy by echocardiography. However, if the shape of
the intracardiac mural thrombus is similar to IDH,
differential diagnosis will become difficult. Thus,
we present the importance of multimodal imaging in diagnosing a rare
case of a 52-year-old man with thrombosed LV aneurysm who was initially
misdiagnosed as IDH.