Idiopathic right ventricular pseudoaneurysm presenting with ventricular tachycardia: a case report

Right ventricular (RV) pseudoaneurysm is very rare and is seen after penetrating chest trauma, cardiac surgery, infective endocarditis, myocardial infarction, syphilis, endomyocardial biopsy, lead extraction. Idiopathic right ventricular pseudoaneurysm is even rarer. They have varied presentations depending on the etiology. Diagnosis is usually made by echocardiography. We present a case of 21-year-old male who presented to us with palpitations for 2 days and one episode of syncope and was diagnosed with monomorphic ventricular tachycardia (VT) and he was managed with electrical cardioversion during one of the episodes. Echocardiogram and CMR showed a larger right ventricular pseudoaneurysm at apex. Surgical excision was done uneventfully. The patient had no further VT episodes post-surgery. This case highlights the approach to diagnosis and management of RV pseudoaneurysm.