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The ST elevation is defined by ≥1 mm in at least two adjacent leads. The ST changes seen in early repolarization are different than the ST changes seen with acute ischemia/infarction that are due to current flow, called "injury current," across the area between ischemic and non-ischemic myocardium. 26Commonly the ECG findings are normal, or there may be evidence of LV volume overload and, rarely, myocardial ischemia. In an older patient with a coronary to right atrium fistula, atrial fibrillation may be present. Results of chest radiographs are usually normal, but there may be cardiomegaly or evidence of congestive heart failure.
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Left ventricular compliance is increased, allowing large ventricular volumes to be accommodated with minimal increase in end-diastolic pressure (see Fig. 1-7 ). As the left ventricular diameter increases, wall tension and hence afterload are increased. There is compensatory systemic vasodilation.Complications. A left ventricular aneurysm can be associated with a variety of complications such as malignant arrhythmias, heart failure, cardiac ischemia, thromboembolism, and rupture of the ventricle. Almost one-third of the patients with ventricular aneurysms develop arrhythmias.
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