Posterior Descending Artery Milking-Like Effect Caused by Ventricle Pseudoaneurysm Compression

A 78-year-old man with a history of smoking, hypertension, and peripheral vascular disease presented with prolonged chest pain during the previous 48 hours. On admission, he was still symptomatic and the ECG showed Q waves and 2-mm ST elevation in leads II, III, and aVF, with a 2-mm persistent ST depression in leads C2 to C5 (Figure 1). Serial cardiac enzymes were positive for myocardial necrosis. Cardiac catheterization showed …