What is the significance of LVH and the old posterolateral MI?

A posterolateral MI is caused by the occlusion of the circumflex artery, a branch of the left coronary artery. This artery supplies the posterolateral left ventricle and anterolateral papillary muscles. Thus, depending on the severity of occlusion, an old posterolateral MI could cause a loss of function of part of the left ventricle and its associated papillary muscles. Such damage would cause weakening of the left ventricle’s ability to sustain systemic blood pressure, both through damage to the ventricle and the mitral valve (through the damage to the papillary muscles). This weakening would result in hypertrophy of the remaining anteromedial muscle of the left ventricle, independent of any other causative factors.