Abstract
BACKGROUND: Left ventricular pseudoaneurysm (LVP) is a serious complication of myocardial infarction, occurring in 0.2% to 0.3% of cases and associated with high morbidity and mortality. Multiloculated pseudoaneurysms are even rarer, and they pose significant diagnostic and therapeutic challenges owing to their complex anatomy and presentation. CASE SUMMARY: We present a 56-year-old man with a multiloculated LVP after myocardial infarction diagnosed via multimodal imaging. Although surgical intervention was advised, the patient opted for conservative management. DISCUSSION: This case presents a rare and complex multiloculated variant, seldom reported in the literature. Reducing total ischemic time is critical to prevent such complications. Early diagnosis through advanced multimodal imaging and timely intervention are essential for improving outcomes. TAKE-HOME MESSAGE: This case underscores the importance of early diagnosis and advanced imaging in managing complex pseudoaneurysms, optimizing outcomes, and guiding treatment decisions.