LAUSR

A 63-year-old woman with a history of perma-nent atrial fibrillation and mitral valve replacement with a mechanical prosthesis underwent outpatient cardiac catheterization due to repeated atypical chest pain. Coronary angiography showed no coronary stenosis, but ventriculography showed focal dilatation of the ventricular wall at the apical level (Fig. 1, A: Systole, B: Diastole), not described in previous imaging studies. Transthoracic echocar-diography showed a short-necked, non-contractile saccular image, located at the apex of the left ventricle (Fig. 1C, D). No wall motion abnormalities were observed. The observed wide neck suggested the diagnosis of aneurysm, but a cardiac magnetic reso-nance showed a lack of continuity in the muscular layer, and a late gadolinium uptake circumscribed to the adjacent epicardial region (Fig.