Massive haemoptysis: an unusual connection

Correspondence to Dr Aimee Leadbetter, Department of Respiratory Medicine, Great Western Hospitals NHS Foundation Trust, Swindon SN3 6BB, UK; aimee.leadbetter@nhs.net Description A 60-year-old man presented with a 4-day history of small volume haemoptysis. CT pulmonary angiogram axial (A) and coronal (B) images on presentation show extensive pericardial calcification and a focal mid-anterolateral myocardial rupture with contrast entering a lateral mid wall false aneurysm from the left ventricle (panel B, arrow). Rarely they can be caused by cardiac surgery, trauma and pericardial infections including tuberculosis.1 2 Rupture can be precipitated by infection weakening the pseudoaneurysm sac.2–6 In such cases, blood is normally contained within the pericardium resulting in tamponade.