Focal myocytolysis mimicking the electrocardiographic pattern of transmural anteroseptal myocardial infarction.

Two patients are documented, one with a cerebral infarct and one with a primary brain tumor, both of whom initially had a normal electrocardiogram but subsequently developed the classic pattern of transmural anteroseptal myocardial infarction; however, in both cases the autopsy proved the electrocardiograph pattern to be related to "focal myocytolysis" of the myocardium. Both patients also exhibited coronary arterial disease of the localized type and to a maximal luminal narrowing of 75 percent without a history of anginal complaints. It is of interest that the intensity of the lesions of focal myocytolysis was greatest in the areas supplied by the affected arteries. This peculiarity suggests that ischemia, though not primarily involved in inducing the lesions, could be of additional significance.