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53-year-old man was referred to our hospital because of developing exertional dyspnea (NYHA functional class II). His electrocardiogram (ECG) had already shown a negative T wave in leads II, III, aVF, and V1–3 at a physical checkup 2 years before. In cardiac catheterization, left ventriculography had revealed a ventricular aneurysm at the basal posterior segment despite normal coronary arteries. Because no symptoms were apparent, however, a wait-and-see approach had been undertaken for 2 years. On admission to our hospital, an ECG showed a negative T wave in leads II, III, aVF, and V1–4. Cardiac cine magnetic resonance imaging (MRI) revealed that there was a second aneurysm that was newly developed at the middle anterior segment, in addition to the first aneurysm (Figure 1). An MRI late gadolinium enhancement was present in both of the aneurysms and in the enlarged right ventricle transmurally, whereas a T2-weighted MRI showed normal myocardial signal intensity. Fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) images obtained after a period of 12 h of fasting showed high FDG accumulation in the basal and apical regions of the left ventricle corresponding to the aneurysms and the hilar lymph nodes (Figure 2). We suspected cardiac sarcoidosis because of the

Second Left Ventricular Aneurysm Newly Developed in a Patient With Untreated Cardiac Sarcoidosis