Electrocardiographic changes simulating a myocardial infarction after cardiac transplantation.

A 39-year-old man with idiopathic dilated cardiomyopathy and New York Heart Association Class III heart failure symptoms underwent orthotopic cardiac transplantation. Post-operatively, he developed an anteroseptal infarct pattern on the electrocardiogram (ECG), without regional wall motion abnormalities according to echocardiography. This pseudo-infarct pattern on ECG resolved within 6 months without coronary intervention or sequelae. It is postulated that these ECG changes were caused by increased left ventricular wall thickness due myocardial wall edema and reperfusion injury after cardiac transplantation.