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Capsular contracture simulating myocardial infarction on ECG

W Peters¹, P McEwan

¹Division of Plastic Surgery, Wellesley Hospital, Toronto, Ontario, Canada.

Plastic and Reconstructive Surgery

|March 1, 1993

Summary

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Severe capsular contracture after breast augmentation can cause electrocardiogram (ECG) artifacts. Corrective surgery resolved the ECG abnormalities, demonstrating the impact of anatomical changes on diagnostic readings.

Area of Science:

Cardiology
Plastic Surgery
Medical Imaging

Background:

Breast augmentation surgery can lead to complications such as capsular contracture.
Capsular contracture can cause significant anatomical distortion around breast implants.

Observation:

A patient with severe bilateral class IV capsular contractures, 16 years post-augmentation, exhibited an electrocardiogram (ECG) pattern suggestive of a septal infarct.
The ECG abnormality was traced to artifactual lead misplacement due to the severe capsular contracture.

Findings:

The V2 and V3 electrocardiogram leads were unavoidably misplaced, creating a false "septal infarct" pattern.
Following open capsulotomy, normal lead placement became feasible, and the ECG reverted to normal.

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Implications:

Severe capsular contracture can mimic serious cardiac conditions on ECG, leading to potential misdiagnosis.
Surgical correction of capsular contracture can resolve ECG artifacts, highlighting the importance of considering anatomical factors in interpreting diagnostic tests.
This case underscores the need for careful clinical correlation when interpreting ECG findings in patients with significant post-surgical anatomical changes.