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Author: Peter Bakes, MD Educational Pearls: Pericarditis, LBBB, LVH and left ventricular aneurysms can all present with ST elevation. Ventricular aneurysm will present days after a cardiac event with ST elevation and Q waves in the affected leads. Ventricular aneurysms may cause papillary muscle dysfunction with a resultant holosystolic murmur and even heart failure. References Victor F. Froelicher; Jonathan Myers (2006). Exercise and the heart . Elsevier Health Sciences. pp. 138–. ISBN 978-1-4160-0311-3. Nagle RE, Williams DO. (1974) Proceedings: Natural history of ventricular aneurysm without surgical treatment. British Heart Journal, 36:1037.