A cardiac pseudo-tumor associated with pseudo-infarction electrocardiographic pattern

Area of Science:

• Cardiology
• Medical Imaging
• Pathophysiology

Background:

• Electrocardiography (ECG) is crucial for diagnosing myocardial infarction (MI), with Q waves indicating infarction.
• Differential diagnoses for Q waves include various cardiac conditions.
• Differentiating structural heart disease from ischemic events is clinically significant.

Observation:

• A patient presented with significant Q waves on ECG (V1-V4).
• Echocardiography revealed an encapsulated mass on the interventricular septum.
• Magnetic resonance imaging (MRI) identified marked myocardial hypertrophy, particularly of the ventricular septum (>3 cm).

Findings:

• The diagnosis was hypertrophic cardiomyopathy (HCM).
• The ECG findings mimicked a cardiac pseudo-tumor with a pseudo-infarction pattern.
• This highlights a rare presentation of HCM.

Implications:

• HCM can present atypically, mimicking myocardial infarction on ECG.
• Advanced imaging like MRI is essential for accurate diagnosis in complex cases.
• Recognizing this pseudo-infarction pattern in HCM can prevent misdiagnosis and guide appropriate management.