Inferior wall STEMI presenting with a ruptured intraseptal pseudoaneurysm.

To cite: Negi P, Bhardwaj R, Asotra S, et al. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/ bcr-2016-214744 DESCRIPTION A 78-year-old man presented with progressively increasing dyspnoea, 2 weeks after experiencing ST elevation inferior wall myocardial infarction that was not thrombolysed because of late presentation. He was Killip class 2 with raised jugular venous pressure. Cardiac auscultation revealed a grade 4 harsh systolic murmur in the lower left parasternal area, and a loud S2 with a prominent right ventricular S3. Echocardiography demonstrated akinetic and thinned out basal inferior and basal inferior septal segments (video 1). A pseudoaneurysm extending from the inferior septum was noticed (video 1 and figure 1A), which was thin