| Summary points: | A 67 year-old patient presents to the emergency department with worsening chest pain and shortness of breath 4 days post acute inferolateral myocardial infarction (MI) with subsequent left circumflex coronary artery stent placement. Chest radiograph, computed tomography, cardiac magnetic resonance imaging, aneurysmorrhaphy, coronary bypass grafting and a mitral valve repair are described; images provided. The authors discuss subendocardial left ventricular aneurysm/impending rupture in a patient with continued chest pain after acute MI, which should be considered as an uncommon yet life-threatening differential diagnoses. |