Unusual presentation of a left ventricular aneurysm

We report on a case of left ventricular aneurysm in a 42-year-old woman presenting with atypical chest pains. The resting electrocardiogram showed abnormal Q and T negative waves in leads II, III, and aVF. Transthoracic echocardiography revealed an aneurysm on the posterior wall of the left ventricle. Thallium myocardial tomoscintigraphy confirmed the presence of a persistent defect with uneven uptake in the posterior wall, and coronary arteriography showed perfectly normal coronary arteries. A left ventricular aneurysm associated with normal coronary arteries and transient ischemia was diagnosed following a comparison with one of the patient's old electrocardiograms.