Abstract
Lipomatous hypertrophy of the interatrial septum is a rare benign condition characterized
by adipocyte hyperplasia with fat infiltration between the myocardial fibers in the
interatrial septum. Although lipomatous hypertrophy does not occur only in the interatrial
septum, its location in the interventricular septum is extremely rare. A 45-year-old
woman with no medical or family history of cardiac disease presented with an episode
of syncope. Transthoracic echocardiography revealed an echogenic mass in the interventricular
septum and no outflow obstruction. The mass-like area showed fat tissue-specific features
on computed tomography and magnetic resonance imaging, and furthermore, it showed
late gadolinium enhancement. We diagnosed it as lipomatous hypertrophy of the interventricular
septum. An implantable loop recorder documented paroxysmal complete atrioventricular
block with presyncope. A permanent dual-chamber pacemaker was implanted. This is the
first reported case of lipomatous hypertrophy of the interventricular septum treated
with a pacemaker for complete atrioventricular block with syncope. We have described
the case and the treatment strategy in detail.
Learning objective
To understand lipomatous hypertrophy, a rare disorder, and its characteristics and
differences between lipomatous hypertrophy and cardiac adipose tumors on computed
tomography and magnetic resonance imaging. To learn about the appropriate treatment
and clinical management of this benign condition and treat symptomatic patients.
Keywords
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Article info
Publication history
Published online: September 28, 2022
Accepted:
August 26,
2022
Received in revised form:
July 30,
2022
Received:
February 28,
2022
Identification
Copyright
© 2022 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
