Pseudoaneurisma Ventricular Izquierdo en Cara Inferior con Flujo Bidireccional Left Ventricular Pseudoaneurysm in inferior wall with bidireccional flow.

Pseudoaneurysms are infrequent myocardial infarction complications. They consist of a small pericardial sac that communicates with the ventricular cavity through a thinner diameter neck. We present a clinical case of a 68-year-old female patient, with DM II and Arterial Hypertension, suffers Acute Myocardial Infarction in May of 2008, presenting dyspnea and cough for a week, with profuse diaphoresis of sudden setting and syncope without precordial pain. The electrocardiogram reports zones of transmural and subendocardial ischemia in inferolateral and lateral walls; respectively, and an electrically inactivable zone in inferior wall. The transthoracic echocardiogram shows left ventricle with severe dilatation, decrease of the ejection fraction (25%) and an inferior wall pseudoaneurysm with a neck of 3 mm through which it is evidenced a bidirectional flow; entering to the ventricle during diastole and exiting to the pseudoaneurysm in systole. Bidirectional flow and decreased heart output help to avoid cardiac tamponade, nevertheless, in conditions of higher demands the pseudoaneurysm could perforate and cause this entity. Therefore, the importance of differential diagnosis with real aneurysm, that allows to carry out the appropriate therapeutic measures and to avoid such