Cardiology · NEET PG Preparation Medicine
A 55-year-old male with a history of anterior ST-elevation myocardial infarction 2 years ago presents with progressively worsening dyspnea on exertio…
Practice question from Cardiology (NEET PG Preparation Medicine), with the correct answer and a step-by-step solution.
medium · MCQ · Q-8FDF24
A 55-year-old male with a history of anterior ST-elevation myocardial infarction 2 years ago presents with progressively worsening dyspnea on exertion and lower extremity edema. Echocardiography reveals a large left ventricular apical aneurysm with a mural thrombus and an ejection fraction of 30%. Which of the following is the most definitive long-term complication associated specifically with this structural cardiac lesion?
- A.Ventricular free wall rupture
- B.Refractory ventricular arrhythmias and systemic thromboembolismCorrect answer
- C.Acute severe mitral regurgitation due to papillary muscle rupture
- D.Paradoxical pulse and constrictive physiology
Solution
A true left ventricular aneurysm is a late complication of transmural myocardial infarction, composed of scarred, non-contractile myocardial tissue. Unlike pseudoaneurysms, true ventricular aneurysms rarely rupture. However, they commonly lead to refractory ventricular arrhythmias due to electrical instability at the scar-viable tissue border zone and systemic thromboembolism from stasis within the akinetic/dyskinetic sac.
More from Cardiology
- A 68-year-old man presents with syncopal episodes. On examination, he has a delayed and weak carotid upstroke (pulsus parvus et tardus) and…
- A 45-year-old female presents with fatigue, dyspnea on exertion, and palpitations. Physical examination reveals an irregular pulse, a loud…
- A 28-year-old competitive athlete collapses during a soccer match and is brought to the emergency department, where he is declared dead. Po…
- A 60-year-old male with chronic heart failure with reduced ejection fraction (HFrEF) is currently on maximally tolerated doses of an ACE in…
Practise more Medicine
Sign up free for adaptive practice on this chapter, with instant feedback and hints on every question.
Start practising freeFree to start · No credit card needed