Cardiac aneurysm

• A true aneurysm is a circumscribed non-contractile out-pouching of the left ventricle.
• Although there is a very rare congenital form, the majority occur as a complication of myocardial infarction. It rarely ruptures, but patients are at risk of arrhythmias and thromboembolic events that occur from clot formation within the aneurysm.
• A pseudo-aneurysm, or false cardiac aneurysm, occurs acutely following trauma or a myocardial infarction, with a focal left ventricular rupture, localised haematoma and a high risk of delayed rupture and death.

Radiological features:

• CXR – localised bulge in the left heart border. There is often a thin 
  peripheral rim of calcification within the ventricular wall.

• Echocardiography – paradoxical movement of the left ventricular 
  wall in systole is diagnostic. The aneurysm may contain thrombus.

Calcified Cardiac Aneurysm.
Note the localized bulge in the heart border, with curvilinear calcification in the left ventricular wall.