An elderly patient dies two years after a healed anterior myocardial infarction. Autopsy reveals a dilated, thin-walled bulge of the left ventricular apex lined by laminated thrombus, with dense fibrous scar in its wall. Which complication was this patient LEAST likely to suffer during life because of this lesion?

• A Systemic arterial embolism
• B Congestive heart failure
• C Ventricular tachyarrhythmia
• D Spontaneous rupture with hemopericardium ✓

Explanation

A true ventricular aneurysm is a late complication whose wall is composed of mature fibrous scar, which is strong enough that rupture almost never occurs, unlike free wall rupture at 3 to 7 days when the wall is soft necrotic muscle. Mural thrombus formation with systemic embolism, progressive heart failure, and ventricular arrhythmias are all well recognized consequences, so options A, B and C remain valid risks.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.