ECG Findings
• ST elevation in anterior contiguous leads
• Deep pathologic Q waves in anterior leads
Clinical Pearls
1. ST segment elevation which occurs in the setting of a myocardial infarction should resolve within days under normal circumstances.
2. Persistent ST-segment elevation occurring for weeks or longer after a myocardial infarction is suspicious for ventricular aneurysm.
3. Ventricular aneurysms may follow a large myocardial infarction in the anterior portion of the heart.
4. The aneurysm consists of scarred myocardium, which does not contract but bulges outward during systole; complications include congestive heart failure, myocardial
rupture, arrhythmias, and thrombus formation.
5. Suspect an LV aneurysm when these findings appear in the ECG of a patient who does not demonstrate symptoms suggesting Acute Coronary Syndrome. However, one should also be vigilant
for the presence of “silent” Acute Coronary Syndrome
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