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.