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Sixty-five consecutive autopsied cases of ventricular aneurysm are reviewed. The incidence of aneurysm following myocardial infarction is similar to that reported in other series. Myocardial infarction preceded the formation of an aneurysm of the ventricle in the vast majority of patients, and a new myocardial infarction was the cause of death of about 50 per cent of them. The survival rate of patients with ventricular aneurysm is not significantly different from the long-term survival of all patients with myocardial infarction found in the same institution. Complications of ventricular aneurysm such as chronic congestive heart failure and rupture of the aneurysm were infrequent causes of death, and systemic embolic phenomena were not observed as a cause of death. In only four patients was the diagnosis made ante mortem. The lack of characteristic clinical, radiologic, and electrocardiographic findings is discussed. It is suggested that the hemodynamic significance of ventricular aneurysms is not ordinarily great, in view of the unaffected statistical prognosis in its presence. The recommended indications for surgery of ventricular aneurysms, based on this retrospective study, are presented.

Depression is an important predictor of morbidity and mortality in patients with coronary disease, particularly after myocardial infarction, independent of previous cardiac history or CAD severity. Depression also is associated with poor long-term psychosocial outcomes. The prevalence of major depression among post-MI patients is 15 to 20%, with an additional 27% reporting symptoms of minor depression. This article briefly reviews the literature on depression in patients with coronary disease, including previously published efforts to treat the disorder in this group. A case review then is provided, highlighting important aspects of treatment.

The Florida Clergy End-of-Life Education Enhancement Project was a model program developed to provide an interdenominational and statewide model of clergy education on loss, grief dying, and death. The authors describe the project including materials and curriculum as well as present data from the project's evaluation. Clergy and their partners in ministry responded enthusiastically to the project. As a whole, they reported higher levels of knowledge on end-of-life (EOL) issues at the conclusion of the training. Clergy and their ministerial teams also reported that they were better informed about the technical, procedural, medical, and legal issues that arise at the end of life and expressed the desire for subsequent training. The project indicates that clergy both recognize the need for additional training and are anxious to improve their abilities to minister to the dying and bereaved. The model presented here could easily be applied to local organizations such as hospices or denominational training.

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