Post-myocardial infarction left ventricular pseudoaneurysm resulting from free wall rupture is a rare finding and its recognition during life is uncommon. The diagnosis is difficult since symptoms, clinical evaluation and electrocardiographic and X-ray findings are usually non-specific. We herein present a case of a pseudoaneurysm manifesting after a silent myocardial infarction and diagnosed at echocardiography in a patient who, at the time of hospitalization, had a history and clinical and laboratory findings suggestive of pulmonary embolism. The patient was successfully operated. The present report underlines the diagnostic and prognostic value of two-dimensional transthoracic echocardiography. The clinical and laboratory findings are also discussed in the light of the recent literature.