Introduction Aneurysm of the heart was described in 1757 when John Hunter1 included a case report in "An Account of the Dissection of Morbid Bodys." For two centuries ventricular aneurysm has remained an interesting pathologic entity and has been displayed prominently in every major collection of postmortem oddities. Occasionally the diagnosis of ventricular aneurysm was established in the living patient,2 an event of interest to the clinician but not helpful to the patient. The recent advent of open-heart surgery and its application in various types of acquired heart disease has made ventricular aneurysm a correctable lesion. This development removes ventricular aneurysm from the sole realm of the pathologist and makes clinical recognition now mandatory. Pathologic Features Historically ventricular aneurysm was associated with syphilis, rheumatic myocarditis, tuberculosis, trauma, and a number of other etiologic factors. In light of present knowledge, however, it appears that ventricular aneurysm is the end