Aneurysm Echocardiogram Ultrasound 
Dr. Smith's ECG Blog
OCTOBER 26, 2010
One very useful adjunct is ultrasound: Echo of his heart can distinguish aneurysm from acute MI by presence of diastolic dyskinesis, but it cannot distinguish demand ischemia from ACS. Furthermore, notice the well-formed Q-waves in inferior leads. These must raise suspicion of old MI with persistent ST elevation.
Dr. Smith's ECG Blog
JUNE 18, 2011
1.196 x STE60 in V3 in mm) + (0.059 x computerized QTc) - (0.326 x RA in V4 in mm) Third, one can do an immediate cardiac ultrasound. The old ECG has a Q-wave with persistent ST elevation in lead III, and some reciprocal ST depression (typical for aneurysm morphology). LV aneurysm is very different for inferior vs. anterior MI.
Dr. Smith's ECG Blog
APRIL 12, 2013
He had diffuse crackles on exam and B-lines on chest ultrasound, and chest x-ray also confirmed pulmonary edema. Inferior LV "aneurysm" morphology Electrocardiographic "LV Aneurysm" morphology simply means "persistent ST elevation after previous MI." On arrival, he was hypoxic, with saturations of 92% on room air.
Dr. Smith's ECG Blog
JULY 18, 2014
An echocardiogram showed no hemopericardium, but D oppler showed a new small ventricular septal defect with left to right shunting. If detected early by ultrasound, the patient can be saved. Additionally , these patients have a high incidence of LV aneurysm with mural thrombus. No resolution of ST elevation. 3) Oliva et al. (4)
Dr. Smith's ECG Blog
APRIL 3, 2019
You might think it is "Old MI with persistent ST Elevation" (otherwise known as "LV aneurysm" morphology.") That is a reasonable thought, but we have shown that if there is one lead of V1-V4 with a T/QRS ratio greater than 0.36, then it is STEMI, not LV aneurysm. These ultrasounds confirm LAD occlusion. What's the story?"
Dr. Smith's ECG Blog
APRIL 8, 2015
Look for Vascular Etiology -- think of these while doing H and P: --Bleeding: ruptured AAA, GI bleed, ruptured ectopic pregnancy, other spontaneous bleed such as mesenteric aneurysms. Aortic Dissection, Valvular (especially Aortic Stenosis), Tamponade. Most physicians will automatically be worried about these symptoms. orthostatic vitals b.
Dr. Smith's ECG Blog
MARCH 3, 2025
There are no Q-waves to suggest old inferior MI, or inferior aneurysm as the etiology of the ST Elevation. I suspect pulmonary edema, but we are not given information on presence of B-lines on bedside ultrasound, or CXR findings. However, there is also significant tachycardia , with heart rate of 116, and known hypoxia.
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