Diagnosis of myocardial infarction-induced ventricular aneurysm in the presence of complete left bundle branch block

John E. Madias, Ramin Ashtiani, Himanshu Agarwal, Moethu Win, Virenjan K. Narayan, Anjan Sinha

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

An analysis of the 4,196 files of our Cardiology Clinic cohort showed 128 patients with a complete left bundle branch block (LBBB) in their electrocardiograms (ECGs). Of these patients, 27 had suffered a myocardial infarction in the past and had been found to have a ventricular aneurysm (VA), documented by ≥1 of several noninvasive and invasive diagnostic methods. Five of these 27 patients had stable ST-segment elevation in ≥1 of left precordial ECG leads, with predominantly positive QRS complexes (an ECG criterion for the diagnosis of VA in the presence of LBBB, which we have recently described). The sensitivity of this ECG criterion for the diagnosis of VA was 18.5%, and the specificity was 100%. The frequency of distribution of VA in the septal, and even more, apical myocardial regions was higher in the patients with a positive ECG diagnosis of VA, than in the patients with a negative one (P = .049, and P = .009, correspondingly). The number of myocardial territories involved with a VA was not different in the 2 subgroups (P = .325). Pathophysiologically, this ECG alteration diagnostic of VA represents a superimposition of the primary ST-segment elevation due to the VA, on the expected secondary ST-segment depression due to the LBBB, and represents a summation effect.

Original languageEnglish (US)
Pages (from-to)147-154
Number of pages8
JournalJournal of Electrocardiology
Volume34
Issue number2
DOIs
StatePublished - Apr 2001

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Keywords

  • ECG
  • Left bundle branch block
  • Myocardial infarction
  • Ventricular aneurysm

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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