A 56-year-old female with a history of well-controlled hypertensionand gastroesophageal ref lux disease presented withan inferolateral ST segment elevation myocardial infarction48 h after the onset of chest pain. She underwent a coronaryangiogram, which demonstrated complete occlusion of the leftcircumflex coronary artery, which was treated with a drugelutingstent. A transthoracic echocardiogram (TTE) performedon Day 3 post acute myocardial infarction (AMI), revealed adilated left ventricle (LV) with near normal systolic function(Fig. 1A). The patient was subsequently discharged home onappropriate medical therapy. She represented 2 weeks laterwith symptoms of decompensated congestive cardiac failure.A repeat TTE revealed significant impairment of LV functionand a prominent LV aneurysm in the lateral wall with theaneurismal neck measuring 57 mm (Fig. 1B). Reconstructed CTimages demonstrated a large aneurysm in the posterolateralwall of the LV (Fig. 2). The mouth of the aneurysm measured64 mm×49 mm. She subsequently had a LV aneurysmectomyand repair with a bovine pericardial patch. A follow-up TTErevealed a significantly smaller residual apicolateral wallaneurysm, with residual moderate impairment of LV function(Fig. 1C).
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