This is the chest X-ray of a patient who suffered from a sudden uniocular 
visual loss. He had a previous history of myocardial infarction.

a. What does the Chest X-ray show?

The heart is enlarged with calcification of the left ventricle.
This is seen in left ventricular aneurysm. This can be confirmed with
echocardiogram.

b. What could be the cause of his sudden visual loss?

The most likely cause of his sudden visual loss is arterial emboli 
arising from left ventricular thrombus.

c. How would you manage this patient?

The patient should be referred to cardiologists for anti-coagulation 
treatment.
Surgical removal of the aneurysm (aneurysmetomy) is indicated if the 
patient is fit.

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