An unusual ECG pattern in restrictive cardimyopathy.

Area of Science:

• Cardiology
• Electrophysiology
• Cardiomyopathy Research

Background:

• Restrictive cardiomyopathy (RCM) is a rare primary cardiomyopathy.
• Electrocardiogram (ECG) abnormalities are present in 99% of RCM patients.
• Characteristic ECG findings include biatrial enlargement and specific ST-T wave changes.

Observation:

• A 16-year-old girl with idiopathic RCM exhibited significant ECG abnormalities.
• The patient presented with diffuse resting ST depression and T wave inversion in precordial and inferior leads.
• ST elevation in lead aVR was also noted, persisting for over six months.

Findings:

• Coronary angiography revealed normal coronary arteries.
• Stress perfusion imaging showed no evidence of myocardial perfusion defects.
• The observed ECG pattern mimicked subendocardial ischemia but was attributed to RCM.

Implications:

• The study emphasizes that RCM can manifest with ECG findings suggestive of ischemia, necessitating careful differential diagnosis.
• Persistent ST depression and T wave inversion in RCM may warrant further investigation beyond typical ischemic protocols.
• This case highlights the importance of considering RCM in young patients presenting with unexplained, persistent ECG abnormalities.