Cardiovascular disease is the leading cause of death in Brazil, and coronary disease is its major component. According to DATASUS acute myocardial infarction, the initial clinical presentation in 40% of patients with coronary disease, caused 56,000 deaths in 1997. Other ominous consequences of infarction are heart failure and ventricular arrhythmia, both strongly related to the extension of infarction.
Left ventricular aneurysm is more frequent after occlusion of left anterior descending branch of the left coronary artery. Several studies revealed that aneurysm is a precocious complication and may be detected in the first two weeks of the infarction. However, only two to three weeks after myocardial infarction the diagnosis of left ventricular aneurysm can be made because the presence of stunned myocardium. So, left ventricle aneurysm is defined as a segment of left ventricle wall that expands or stay akynetic in the systole in patients out of acute phase or early convalescence period after myocardial infarction.
Left ventricular aneurysm is associated with poor prognosis however some trials have not attributed that to the aneurysm itself but to lower global ejection fraction. Usually aneurysm is related to poor left ventricle ejection fraction, greater prevalence of ventricular arrhythmia and sudden death.
Surgery is reserved to patients with symptoms of congestive heart failure, large aneurysm, left ventricular enlargement, systolic dysfunction and frequent or malignant ventricular arrhythmia.