Ventricular pseudoaneurysm rupture is a rare finding in emergency departments in the era of percutaneous coronary intervention. It is an infrequent complication after acute myocardial infarction. We present a case of ventricular pseudoaneurysm rupture and examine current literature on the pathophysiology and imaging guidelines on the topic. The patient is a 58-year-old male that presented to the emergency department with dizziness and syncope. Imaging in the emergency department included computed tomography of the chest and an ultrasound that showed pseudoaneurysm with hemopericardium and early cardiac tamponade. He was treated surgically. Ventricular pseudoaneurysm rupture is an uncommon finding in medicine and the emergency department. Point-of-care ultrasound is an important diagnostic modality to identify this critical complication and prompt surgical management.