On the electrocardiogram and clinical improvement after myocardial aneurysmectomy

A case is reported to show that removal of a huge ventricular aneurysm does not necessarily lower resting left ventricular end-diastolic pressure and that reduction of elevated left ventricular end-diastolic pressure is not essential for clinical improvement to occur after myocardial aneurysmectomy. Some possible causes of clinical improvement are discussed. It is suggested that clinical improvement after operation in the patient reported might be due to saving of energy required to move the akinetic mass of aneurysm and to a more normal and therefore more effective ventricular contraction, and that the latter is reflected in the tendency towards normalization of the ECG after operation.