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

Olatunde Ola, Carissa Dumancas, Tuoyo Omasan Mene-Afejuku, Adedoyin Akinlonu, Mohammed Al-Juboori, Ferdinand Visco, Savi Mushiyev, Gerald Pekler

(Department of Medicine, New York Medical College, Metropolitan Hospital Center, New York, NY, USA)

Am J Case Rep 2017; 18:410-413

DOI: 10.12659/AJCR.902884

BACKGROUND: 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.

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