ECG Quest > Diagnoses > STEMI Mimics > LV aneurysm

LV aneurysm

A left ventricular aneurysm causes persistent ST elevation 2 or more weeks after an acute infarction. On echocardiography there is paradoxical wall movement.

It can be difficult to tell apart LV aneurysm from re-infarction. An aneurysm is less likely to have dynamic or reciprocal changes and more likely to have a T:QRS ratio < 0.36 in all chest leads. An infarction is more likely to have ongoing chest pain and haemodynamic instability.

See also: STEMI Mimics

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In the ECGquest archives, this ECG has been tagged with: - LV aneurysm Old anterior MI 12-Lead Dr Smith's ECG Blog CC BY-NC
Is this new LAD occlusion with ST Elevation superimposed on old QS-wave MI?

This ECG is from a middle aged male who presented with a choking feeling in his throat, on a background of prior anterior STEMI complicated by cardiac arrest, and ICD.

This ECG shows QS waves with ST elevation in anterior leads. The T waves were larger than previous, so he was sent to the cath lab, but angiography was normal.

In the ECGquest archives, this ECG has been tagged with: - LV aneurysm 12-Lead Dr Smith's ECG Blog CC BY-NC
I was handed this ECG at triage with no information

This ECG is from a man in his 50s who presented with a syncopal event.

This ECG shows comparison to baseline ECGs suggested an old MI with persistent ST elevation (LV aneurysm).

In the ECGquest archives, this ECG has been tagged with: - Chest pain Anterior ST elevation Pathological Q waves LV aneurysm 12-Lead Dr Smith's ECG Blog CC BY-NC
Classic LV aneurysm (persistent ST elevation after previous MI)

This ECG is from a man in his 70s who presented with acute chest pain on a background of a recent CABG.

This ECG shows deep anterior Q waves suggesting an old infarct , with persistent ST elevation suggesting a left ventricular aneurysm.