Julyeth F. Urbano, Cardiología Pediátrica, Facultad de Medicina, Universidad del Rosario; Fundación Cardioinfantil-La Cardio; Bogotá, Colombia
Christian E. Sanabria, Servicio Electrofisiología Pediátrica, Fundación Cardioinfantil-La Cardio, Bogotá, Colombia
Julián F. Forero, Imágenes Cardiovasculares, Fundación Cardioinfantil-La Cardio, Bogotá, Colombia
Álvaro E. Arenas, Servicio Electrofisiología Pediátrica, Fundación Cardioinfantil-La Cardio;; Posgrado, Universidad del Rosario. Bogotá, Colombia
Primary cardiac tumors are rare in children; lipomas involving the interventricular septum represent an exceptional location and pose a diagnostic challenge due to their arrhythmogenic potential. We report the case of a 16-year-old adolescent presenting with palpitations and presyncope. During emergency department admission, Holter monitoring documented ventricular ectopic beats with two morphologies, episodes of non-sustained ventricular tachycardia (NSVT), and an arrhythmic burden of 16%. Initial echocardiography revealed an echogenic mass within the interventricular septum. Cardiac magnetic resonance imaging (CMR) confirmed the lipoma diagnosis by identifying an intramyocardial mass with adipose tissue characteristics (a hyperintense signal on SSFP and PSIR sequences). Given the patient’s clinical stability and the depth of the lesion, a conservative management strategy with bisoprolol was chosen, yielding favorable outcomes. At three-month follow-up, there was a significant reduction in the arrhythmic burden to 2%, along with complete symptom resolution. This case highlights the fact that accurate tissue characterization by CMR is essential for establishing this diagnosis and supports the consideration of a conservative manage
Keywords: Cardiac lipoma. Interventricular septum. Ventricular tachycardia. Cardiac magnetic resonance. Ventricular arrhythmias.
