Pseudomyocardial infarction associated with acute bifascicular block due to hyperkalemia

A case with lymphocytic lymphoma showing unusual ECG findings consisting of pseudoacute anteroseptal myocardial infarction associated with acute bifascicular block (a combination of right bundle branch block and left anterior hemiblock) secondary to hyperkalemia is presented. To our knowledge, this is the first reported case showing such unusual hyperkalemia-induced ECG abnormalities. No evidence of myocardial infarction (acute or old) was found in this case on the post-mortem examination. The importance of recognizing pseudomyocardial infarction in hyperkalemia is emphasized to distinguish from true myocardial infarction. In addition, it has been stressed that hyperkalemia is one of the important causes of acute bifascicular block.