Massive inferior wall aneurysm presenting with ventricular tachycardia and refractory cardiomyopathy requiring multiple interventions: A case report

Figure 1 12-lead electrocardiograms showing an inferior ST-segment elevation myocardial infarction and ventricular tachycardia respectively. A: 12-lead electrocardiogram one month earlier showing sinus rhythm with a ventricular rate of 90 beats per minute, left axis deviation, pathologic Q waves with 2-3 mm ST-segment elevation in inferior leads (III > II) and avF, and reciprocal ST depression in I and avL; B: 12-lead electrocardiogram showing ventricular tachycardia (VT) with a left bundle branch block morphology, ventricular rate of 150 beats per minute, left superior axis, poor precordial R wave progression, V2 transition suggesting inferoseptal origin of scar-related VT.

Figure 2 A large inferior wall left ventricle aneurysm shown on transthoracic echocardiography parasternal short-axis view in mid-diastole. LV: Left ventricle.

Figure 3 Coronary computed tomography angiography. Still axial coronary computed tomography images reveal an enlarged left ventricle (LV) (1) identified by the blue arrow and a true infero-basal wall LV aneurysm (2) identified by the red arrow significantly reducing aortic ejection LV stroke volume. LV: Left ventricle.

Figure 4 3-D reconstruction of the computed tomography angiography images with the anteroposterior and posteroanterior views in the systolic phase demonstrating an aneurysm (orange arrow) in the inferior wall’s basal region. A: Anteroposterior; B: Posteroanterior.