A 66 year old man presents 2 months after a large anterior myocardial infarction because of persistent fatigue and exertional dyspnea. ECG shows persistent ST segment elevation in the anterior leads. Echocardiography demonstrates a dyskinetic bulge of the left ventricular wall. Which of the following is the most likely diagnosis?
- A)Papillary muscle rupture
- B)Ventricular septal rupture
- C)Dressler syndrome
- D)Ventricular aneurysmGABARITO
- E)Free wall rupture
Explicação
Ventricular aneurysm is correct. Late after a transmural MI, scarred myocardium can bulge paradoxically during systole, causing heart failure, arrhythmias, and mural thrombus formation. Persistent ST elevation long after infarction is a classic clue. Ver explicação completa e trilha adaptativa →