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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
Summary
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.