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An asymptomatic aneurysm of the left ventricle was discovered incidentally in a policeman aged 25, who had a history of a severe thoracic injury from a shotgun wound at the age of 15. Electrocardiography showed a transmural antero-lateral infarct; this was later confirmed at ventriculography. Coronary arteriography showed a narrowed anterior descending artery which crossed over the surface of the aneurysm. The cardiac status remained unchanged over an 8 year follow up period. The pathogenesis is discussed: a fold of contused myocardium, or immediate or late traumatic obstruction of the anterior descending artery, or both factors at the same time?
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