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Acute perimyocarditis mimicking transmural myocardial infarction
Hesham R Omar1, Ahmed Fathy, Rania Rashad
1Department of Cardiology, Cairo University Hospital, Cairo, Egypt. hesham_engy2008@yahoo.com.
International Archives of Medicine
|December 17, 2009
Summary
Diagnosing acute pericarditis can be challenging when electrocardiogram (ECG) changes mimic ST-segment elevation myocardial infarction (MI), especially with elevated cardiac biomarkers. Accurate differentiation is crucial to avoid harmful treatments and missed diagnoses.
Area of Science:
- Cardiology
- Diagnostic Medicine
Background:
- Acute pericarditis typically presents with diffuse electrocardiographic (ECG) changes.
- Myocarditis co-occurrence can elevate cardiac biomarkers, complicating differential diagnosis with acute ST-segment elevation myocardial infarction (MI).
- Misdiagnosis can lead to adverse outcomes, including inappropriate thrombolytic therapy for pericarditis or missed transmural MI.
Purpose of the Study:
- To highlight the diagnostic challenges in differentiating acute pericarditis from acute ST-segment elevation myocardial infarction (MI).
- To raise awareness among clinicians regarding overlapping presentations and critical diagnostic considerations.
Main Methods:
- Case report of an 18-year-old male presenting with severe chest pain.
- Analysis of focal ECG changes and elevated cardiac enzymes mimicking transmural MI.
- Review of diagnostic criteria for acute pericarditis and MI.
Main Results:
- The patient's presentation mimicked acute transmural MI due to focal ECG changes and elevated cardiac enzymes.
- This case underscores the potential for diagnostic confusion between acute pericarditis and MI.
Conclusions:
- Accurate differentiation between acute pericarditis and acute ST-segment elevation myocardial infarction (MI) is critical for appropriate patient management.
- Clinicians should maintain a high index of suspicion for pericarditis even with atypical ECG findings and elevated cardiac biomarkers.
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