Cardiology: left ventricular aneurysm after infarction: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Cardiology: left ventricular aneurysm after infarction

Sample item

Six weeks after an extensive anterior myocardial infarction, a man has no chest pain but his ECG still shows ST elevation with Q waves in V1 to V4. He has had two episodes of sustained ventricular tachycardia. Which complication is most likely?

AEarly post-infarction pericarditisBRecurrent infarction in the same territoryCLeft ventricular aneurysmDPost-infarction Dressler syndrome

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Left ventricular aneurysm

ST elevation that persists for more than a few weeks after an anterior infarction suggests a ventricular aneurysm, a thinned, dyskinetic scar. It predisposes to ventricular arrhythmias, mural thrombus with embolism and heart failure. Echocardiography confirms it.

Option by option

A. Early post-infarction pericarditis
Early pericarditis appears in the first days and settles quickly.
B. Recurrent infarction in the same territory
Reinfarction would cause fresh chest pain and a new troponin rise.
C. Left ventricular aneurysm (correct)
Correct. Persistent ST elevation with Q waves long after the infarct and ventricular arrhythmias fit an aneurysm.
D. Post-infarction Dressler syndrome
Dressler syndrome presents weeks later with fever, pleuritic pain and a rub, and ST elevation is diffuse.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Left ventricular aneurysm. ST elevation that persists for more than a few weeks after an anterior infarction suggests a ventricular aneurysm, a thinned, dyskinetic scar.

Why is "Early post-infarction pericarditis" not the answer?

Early pericarditis appears in the first days and settles quickly.

Why is "Recurrent infarction in the same territory" not the answer?

Reinfarction would cause fresh chest pain and a new troponin rise.

Why is "Post-infarction Dressler syndrome" not the answer?

Dressler syndrome presents weeks later with fever, pleuritic pain and a rub, and ST elevation is diffuse.

What concept does this question test?

It tests Cardiology: left ventricular aneurysm after infarction in General Medicine. It predisposes to ventricular arrhythmias, mural thrombus with embolism and heart failure. Echocardiography confirms it.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiology: left ventricular aneurysm after infarction?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.