A 55 year old man returns for routine follow up 6 weeks after an MI. He gets breathless when walking uphill

A 63 year old man continues to experience chest pain and has a temperature of 37.8˚C 2 days
after an acute MI. His ECG shows widespread ST elevation with upward concavity. What is the
single most likely explanation for the abnormal investigation?

  • a. Acute pericarditis
  • b. Cardiac tamponade
  • c. Atrial thrombus
  • d. Left ventricular aneurysm
  • e. Dressler syndrome

0 voters

Ans. The key is A. Acute pericarditis. [Chest pain, raised temperature and ECG findings of widespread ST
elevation with upwards concavity is diagnostic of acute pericarditis particularly after MI].

A 55 year old man returns for routine follow up 6 weeks after an MI. He gets breathless when walking uphill. His ECG
shows ST elevation in leads V1, V2, V3 and V4. What is the single most likely explanation for the abnormal
investigation?

  • a. Heart block
  • b. Right ventricular strain
  • c. Atrial thrombus
  • d. Left ventricular aneurysm
  • e. Dressler’s syndrome

0 voters

Ans. The key is D. Left ventricular aneurism. [Left ventricular aneurysm is defined as a localized area of myocardium with
abnormal outward bulging and deformation during systole and diastole. Clinically, ventricular aneurysms may be recognized
late with features of heart failure and persistent ST elevation. Risk factors for these aneurysms after acute MI include the
following:
• Female sex
• Total occlusion of the left anterior descending (LAD) coronary artery
• Single-vessel coronary artery disease (CAD)
• Absence of previous angina pectoris].