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Published on: June 20, 2014
Focal myocarditis mimicking acute ST-elevation myocardial infarction: diagnosis using cardiac magnetic resonance
Jeffrey M Testani1, Daniel M Kolansky, Harold Litt
1Division of Cardiovascular Medicine, University of Pennsylvania School of Medicine and Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
Abstract:
The clinical presentation of myocarditis is variable and often mimics myocardial infarction. The diagnosis of acute myocarditis is frequently empiric, and is made on the basis of the clinical presentation, electrocardiographic changes, elevated cardiac enzymes, and lack of epicardial coronary artery disease. To date, the only widely available method for the diagnosis of myocarditis is myocardial biopsy. This procedure, although very specific, has limited sensitivity and substantial procedural morbidity and mortality rates. We present the case of a young woman who presented with chest pain and dramatic anteroseptal ST-segment elevation on electrocardiography. The diagnosis of acute myocarditis was eventually confirmed with use of cardiac magnetic resonance imaging.
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