Left Ventricular Aneurysm May Not Manifest as Persistent ST Elevation on Electrocardiogram.

Abstract

Patient: Male, 67Final Diagnosis: Left Ventricular aneurysm post myocardial infarctionSymptoms: Chest painMedication: Dual antiplatelet therapy • anticoagulationClinical Procedure: Cardiac catheterizationSpecialty: CardiologyObjective:Unusual clinical courseBackground:Electrocardiographic presentations of left ventricle aneurysms are diverse; however, a persistent ST segment elevation post myocardial infarction is most commonly reported.Case Report:The authors present a case of a 67-year-old man who presented to the emergency department after three days of chest pain and was found to have an acute myocardial infarction with an incidental finding of a left ventricular aneurysm. His surface electrocardiogram, however, demonstrated only inverted T waves in the precordial leads. He had a very elevated serum troponin I consistent with an acute myocardial injury which prompted a cardiac catheterization with angioplasty. Post angioplasty, he had persistent T wave inversions in the precordial leads.Conclusions:It is important for clinicians to appreciate that the presence of newly inverted T waves in patients with a late presentation post myocardial infarction should raise a concern for a possible left ventricular aneurysm.