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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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Left Ventricular Aneurysm May Not Manifest as Persistent ST Elevation on Electrocardiogram

Olatunde Ola1, Carissa Dumancas1, Tuoyo Omasan Mene-Afejuku1

  • 1Department of Medicine, New York Medical College, Metropolitan Hospital Center, New York, NY, USA.

The American Journal of Case Reports
|April 17, 2017
PubMed

Insights

Persistent T wave inversions after myocardial infarction can indicate a left ventricular aneurysm. This case highlights the importance of considering this diagnosis in patients with evolving electrocardiogram changes.

Area of Science:

  • Cardiology
  • Medical Diagnostics

Background:

  • Electrocardiographic (ECG) findings in left ventricular aneurysms (LVA) are varied.
  • Persistent ST segment elevation post myocardial infarction (MI) is the most common ECG presentation of LVA.

Observation:

  • A 67-year-old man presented with chest pain and acute MI, incidentally found to have an LVA.
  • His initial ECG showed only inverted T waves in precordial leads, not typical ST elevation.
  • Serum troponin I was elevated, confirming acute myocardial injury.

Findings:

  • The patient underwent cardiac catheterization and angioplasty.
  • Post-procedure, T wave inversions persisted in the precordial leads.
  • These findings were associated with the incidentally discovered left ventricular aneurysm.

Implications:

  • Clinicians should consider left ventricular aneurysm in patients with late post-MI presentations.
  • Newly inverted T waves in precordial leads warrant concern for LVA, even without ST elevation.
  • Recognizing diverse ECG presentations is crucial for accurate LVA diagnosis.

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