Key result
Conservative observation yields stable 10-month outcomes in infant cardiac rhabdomyoma presenting with ST elevation.
Why the study?
Cardiac rhabdomyoma can present with marked ST-segment elevation on ECG in infants, but the clinical significance and course of such ischemic-appearing changes are not well characterized.
Case Report (n=1)
Cardiac rhabdomyomas in infants can present with marked ST-segment elevation mimicking ischemia but may follow a benign clinical course requiring only observation.
Marked ST elevation may occur without ischemia in asymptomatic infants with rhabdomyoma; this case leaves open whether ECG changes alter management in TSC.
BACKGROUND: Cardiac rhabdomyoma is the most common primary cardiac tumor in infancy and is frequently associated with tuberous sclerosis complex (TSC). CASE SUMMARY: A 5-month-old asymptomatic infant presented with electrocardiography (ECG) showing marked ST-segment elevation in the anterolateral and inferior leads. Echocardiogram showed a cardiac rhabdomyoma in the left ventricle with preserved ventricular function and no evidence of hemodynamic compromise. Cardiac biomarkers were negative. There was no other evidence, clinically or radiologically, for TSC. Genetic testing for TSC was also negative. The infant remained clinically well with persistent but stable ECG changes at 10-month follow-up. DISCUSSION: This case highlights a rare but striking ECG presentation of a benign cardiac tumor, emphasizing the importance of clinical context when interpreting ischemic-appearing ECG changes in infants. TAKE-HOME MESSAGES: Cardiac rhabdomyomas may present with marked ST-segment elevation on ECG, even in the absence of symptoms or myocardial injury. Ischemic-appearing ECG changes in infants with cardiac tumors may follow a benign clinical course and warrant careful longitudinal assessment rather than immediate intervention.
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EI et al. (2026) conducted a case report in Cardiac rhabdomyoma (n=1). Cardiac rhabdomyoma was evaluated. An asymptomatic 5-month-old infant with a cardiac rhabdomyoma presented with marked ST-segment elevation but remained clinically well without intervention at 10-month follow-up.
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