Clinical diagnosis and prognosis of ventricular aneurysm.

Where a full thickness infarct has occurred with replacement of myocardium by fibrous tissue, this inert portion of the ventricular wall cannot take part in concentric contraction and herniates outwards during ventricular systole. This localized disturbance of ventricular contraction after acute myocardial infarction is seen not only in large ventricular aneurysms but alsowith smaller full thickness infarcts (minor aneurysms) that have not caused a definite protrusion of the external surface of the heart. In this paper the range of localized disorders of ventricular contraction has been studied clinically, radiologically, at operation, and at necropsy. In diagnosis, special emphasis has been placed on abnormalities of the cardiac impulse, readily appreciated at the bedside, and on the information obtained from detailed fluoroscopy. The prognosis after acute myocardial infarction depends not only on the possibility of a further infarct occurring, but also on the degree of damage that the infarct has inflicted on the ventricles as an efficient pump. The influence of major and minor aneurysms on prognosis following myocardial infarction has been examined.