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Patient
79-year-old woman, diabetic, hypertensive, with prior anteroseptal infarction 3 years earlier with late reperfusion after nine hours (proximal LAD thrombosis); altered left ventricular ejection fraction (30%); numerous nonsustained VT episodes; routine consultation;
Trace
Sinus rhythm, normal PR interval; wide QRS with complete right bundle branch block pattern (QRS> 120 ms, qR pattern in V1 with delayed intrinsicoid deflection, wide S wave in V6, right axis); prior anteroseptoapical infarction (Q-wave and poor R wave progression from V1 to V4); moderate elevation in V3 with repolarization disorders from V1 to V4;
Exergue
The presence of a sustained elevation remote from a transmural infarction should evoke the presence of a left ventricular aneurysm.
This patient presented with anteroseptoapical necrosis with the presence of an anteroapical aneurysmal pouch at cardiac ultrasound.