Question

Infarcts involving which portion of the myocardium most commonly cause a ventricular aneurysm as a post-MI complication?

• A. Subendocardial
• B. Anterior transmural
• C. Posterior transmural
• D. Inferior wall

Hint:

True LV aneurysm follows antero-apical (LAD) transmural infarction.

Answer 1

The Correct Option is B

Step 1: A true left ventricular aneurysm is a late complication of a large transmural myocardial infarction. The infarcted full-thickness wall heals into thin fibrous scar that bulges (dyskinesis) outward during systole.
Step 2: The classic site is the antero-apical wall, which follows occlusion of the left anterior descending (LAD) artery. An anterior transmural infarct is the one that most often produces an apical aneurysm, so option b is correct.
Step 3: A subendocardial infarct (a) spares the outer wall and does not thin the full thickness, so it does not form a true aneurysm. Posterior (c) and inferior (d) wall infarcts are far less commonly associated with aneurysm formation than the anterior wall.
Step 4: The embedded explanation itself states the aneurysm follows antero-apical infarction after LAD occlusion, which corresponds to the anterior transmural option, not the inferior wall.