ArticleJACC. Case reports2026
Midventricular Hypertrophic Cardiomyopathy With Apical Aneurysm Presenting as Persistent ST-Segment Elevation Mimicking Acute Myocardial Infarction.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundST-segment elevation on electrocardiography is classically associated with acute transmural myocardial ischemia due to coronary artery occlusion and is central to the diagnosis of ST-segment elevation myocardial infarction. However, persistent ST-segment elevation may also reflect nonischemic structural heart disease. CASE SUMMARY: A 62-year-old woman presented with chest pain and widespread ST-segment elevation with T-wave inversion. Coronary angiography showed no obstructive disease. Echocardiography and cardiac magnetic resonance revealed midventricular hypertrophic cardiomyopathy with systolic midcavity obstruction and a left ventricular apical aneurysm. Nonsustained ventricular tachycardia was documented, and an implantable cardioverter-defibrillator was placed for primary prevention. DISCUSSION: This case illustrates a rare, high-risk hypertrophic cardiomyopathy phenotype in which persistent ST-segment elevation mimics acute myocardial infarction. TAKE-HOME MESSAGES: Midventricular hypertrophic cardiomyopathy with apical aneurysm can present with persistent ST-segment elevation and T-wave inversion, mimicking myocardial infarction. Electrocardiography is a valuable diagnostic and surveillance tool in this phenotype, as characteristic ST-segment abnormalities may precede or complement imaging findings.
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