Focal Myocarditis Mimicking Subendocardial Ischaemia: a Case Report

Year 2020, Volume: 11 Issue: 4, 122 - 124, 28.12.2020

Hüseyin Avni Demir , Fikret Bildik , Gultekin Kadi

https://doi.org/10.33706/jemcr.805411

Abstract

Introduction:
Myocarditis is an infrequent, possibly life-threatening, and inflammatory myocardial disease with various
number of clinical complaints and symptoms, often caused by infectious agents.
Case Presentation:
A 24‑year‑old male came to the emergency department (ED) with the complaints of angina-like retrosternal chest pain and tightness lasting for three days. The ECG suggesting inferior submural ischaemia and echocardiographic assessment was normal. Laboratory tests showed troponin T levels increased. Coronary angiography was normal. CMRI showed patchy contrast uptake. It looked more like viral myocarditis.
Conclusion:
Acute myocarditis diagnosis is most difficulty and predictively in connection with the variety of clinical presentations. The differential diagnosis between myocarditis and AMI can be troublesome in ED.

Keywords

angina pectoris, endomyocardial biopsy, ischaemia, myocarditis

References

• Referans1. Blauwet, L.A. and L.T. Cooper, Myocarditis. Prog Cardiovasc Dis, 2010;52(4):274-88.
• Referans2. Chrysohoou, C., et al., Acute myocarditis from coxsackie infection, mimicking subendocardial ischaemia. Hellenic J Cardiol, 2009;50(2):147-50.
• Referans3. Costantini, M., et al., Myocarditis with ST-Elevation Myocardial Infarction presentation in young man. A case series of 11 patients. Int J Cardiol, 2005;101(1):157-8.
• Referans4. Morgera, T., et al., Electrocardiography of myocarditis revisited: clinical and prognostic significance of electrocardiographic changes. Am Heart J, 1992;124(2):455-67.
• Referans5. Smith, S.C., et al., Elevations of cardiac troponin I associated with myocarditis. Experimental and clinical correlates. Circulation, 1997;95(1):163-8.
• Referans6. Hufnagel, G., et al., The European Study of Epidemiology and Treatment of Cardiac Inflammatory Diseases (ESETCID). First epidemiological results. Herz, 2000;25(3):279-85.
• Referans7. Escher, F., et al., New echocardiographic findings correlate with intramyocardial inflammation in endomyocardial biopsies of patients with acute myocarditis and inflammatory cardiomyopathy. Mediators Inflamm, 2013;2013:875420.
• Referans8. Hsiao, J.F., et al., Speckle tracking echocardiography in acute myocarditis. Int J Cardiovasc Imaging, 2013;29(2):275-84.
• Referans9. Zhang, T., et al., Acute myocarditis mimicking ST-elevation myocardial infarction: A case report and review of the literature. Exp Ther Med, 2015;10(2):459-464.