[Myocarditis simulating myocardial infarction]

Area of Science:

• Cardiology
• Infectious Diseases
• Hematology

Background:

• Myocarditis, inflammation of the heart muscle, can present with symptoms mimicking myocardial infarction.
• Infectious mononucleosis is a common viral illness that can have varied clinical presentations.

Observation:

• A case where acute myocarditis, secondary to infectious mononucleosis, initially presented as myocardial infarction.
• Initial blood work was unremarkable, delaying the correct diagnosis.
• Subsequent blood and serological tests were crucial for diagnosis.

Findings:

• The diagnosis was revised to include acute porphyria, also triggered by infection.
• Cardiac manifestations of infection can precede overt signs of the infectious disease.

Implications:

• Myocarditis should be a differential diagnosis in young patients presenting with myocardial infarction.
• Consider myocarditis in older patients with myocardial infarction and concurrent infectious symptoms.
• Repeated diagnostic evaluations may be necessary when cardiac symptoms appear before infectious disease symptoms are evident.