Statistics from Altmetric.com
A 37-year-old man referred for non-cardiac chest pain evaluation to our tertiary care centre. There were no risk factors for coronary artery disease. Clinical examination and 12-lead ECG were normal. Transthoracic echocardiogram revealed a finger-like projection in the paraseptal region towards the left ventricle (LV) measuring 5×1.4 cm (figures 1⇓⇓–4; videos 1⇓–4).Grossly, it was mimicking LV mass without any gradient across (as opposed to hypertrophic cardiomyopathy). There was no evidence of left ventricular hypertrophy (neither concentric nor eccentric). Echotexture was the same as that of septum. MRI was performed to characterise the finger-like projection (figures 5 and 6; video 5). It proved to be a hypertrophied muscle band in LV as no different MR signals (hyperintense or hypointense) were found on cardiac MRI. Patient is on follow-up with crucial vigilance regarding any rhythm disturbance without any medications currently. A hypertrophied muscle band in LV can sometimes mimic apical cardiomyopathy1 or LV mass. It is a rare echocardiographic finding in patients with normal LV wall thickness. Sometimes these bands may be associated with rhythm2 disturbances but most of the cases have benign course. We confirmed our finding by cardiac MRI which is better for tissue characterisation.
Hypertrophied muscle band in the left ventricle (LV) can mimic LV mass.
The best way to differentiate it from mass is MRI which is better for tissue characterisation.
Although in most cases it is benign, sometimes it can cause rhythm disturbances or can produce gradients in the left ventricular outflow tract like hypertrophic cardiomyopathy.
The authors are thankful to Mrs Mythri K Gowda for his kind support and cooperation.
Contributors All authors were involved in the writing of this article and with patient care.
Competing interests None.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.