- Apical hypertrophy (Yamaguchi syndrome) can mimic wellen’s syndrome.
Wellens’ syndrome should not be diagnosed in the presence of LVH.
- HOCM can mimic anterolateral MI by producing deep (“dagger like”) Q wave
– Q wave in MI should be at least >40 ms width, but HOCM Q wave typicall is <40 ms.
– Pathogenesis is septal hypertrophy can prolong the initial L-R depolarization in the septum, causing deep Q waves in lateral leads.
Compare with MI
- LAHB may cause posteriorly directed force (by left posterior fascicle) resulting in q wave in V1-V3 (anterior precordial leads), mimicking MI.
From Nelson’s ECG http://www.nelsonsekgsite.com/current/March%202015%20NNA%20scans-3021-3026.pptx
Bottom line in this month:
- LAHB, HOCM and apical hypertrophy may mimic infarction, beware !