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16 April 2017 : Case report  USA

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

Unusual clinical course, Educational Purpose (only if useful for a systematic review or synthesis)

Olatunde Ola1ABCDEF, Carissa Dumancas1ABDEF, Tuoyo Omasan Mene-Afejuku1ABEF, Adedoyin Akinlonu1CDEF, Mohammed Al-Juboori1CDEF, Ferdinand Visco2CDE, Savi Mushiyev2CDE, Gerald Pekler2CDE

DOI: 10.12659/AJCR.902884

Am J Case Rep 2017; 18:410-413

Abstract

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.

Keywords: Anterior Wall Myocardial Infarction, Electrocardiography, Heart Aneurysm

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923