We report here the case of a patient with large left ventricular apical aneurysm incidentally discovered seven years after an inferior myocardial infarction. The aneurysm was successfully corrected by surgery. However, five months after surgery, the patient's evolution was complicated by the sudden occurrence of a pseudoaneurysm. This case is complex and interesting because of several factors, including the incidental discovery, the atypical localization of an aneurysm secondary to the right coronary chronic occlusion, the size of the aneurysm, the preoperative differential diagnosis and the unusual late postoperative evolution.