Massive Calcified Intramural Hematoma of the Right Ventricular Free Wall with 31-year Follow-up

A 21-year-old girl presented with an episode of ventricular tachycardia in September 1991. She was found to have a large (8 cm × 5 cm) mass in the right ventricle and was operated. The mass was full of thrombi and fresh blood that was evacuated. She remained asymptomatic till May 2022, when she presented with another episode of ventricular tachycardia. She also had a history of effort angina of 2 months' duration. Multimodality imaging evaluation revealed a large calcific cystic mass in the right ventricular free wall with an unruptured aneurysm of the right sinus of Valsalva, a markedly distorted right ventricular cavity, and the Brugada pattern of electrocardiogram. The case is reported for its rarity, long follow-up, and strikingly high-quality images.