ABSTRACTWe introduced a case of a 69‐year‐old female patient with mitral valve prolapse with severe regurgitation who was transferred from the ICU to a regular ward after undergoing mitral valve replacement surgery. Routine ECG examination showed that the precordial leads were affected by the apical pulsation, leading to pseudo‐ST segment depression and prolonged QT interval. In clinical practice, ECG artifacts caused by apical pulsation, if not carefully distinguished, may lead to unnecessary examinations and treatments for patients. Our case emphasizes the importance of accurately identifying ECG artifacts.