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Acute myocarditis triggering coronary spasm and mimicking acute myocardial infarction

Andreas Kumar1, Rodrigo Bagur1, Patrick Béliveau1

  • 1Andreas Kumar, Rodrigo Bagur, Patrick Béliveau, Jean-Michel Potvin, Pierre Levesque, Nancy Fillion, Benoit Tremblay, Valérie Gaudreault, Division of Cardiology, Department of Medicine, Quebec University Hospital Centre, Quebec, G1R 2J6, Canada.

World Journal of Cardiology
|October 3, 2014
PubMed

Insights

Acute myocarditis can trigger coronary artery spasm, mimicking a heart attack. Cardiovascular magnetic resonance imaging is crucial for diagnosing this rare condition in patients with chest pain and normal coronary arteries.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Myocardial Diseases

Background:

  • Chest pain with ST-segment elevation typically suggests myocardial infarction.
  • Coronary artery spasm can cause chest pain and ECG changes, but is often transient.
  • Differentiating causes of ST-segment elevation is critical for appropriate patient management.

Observation:

  • A young, healthy male presented with recurrent chest pain and inferior ST-segment elevation.
  • Coronary angiography revealed angiographically normal coronary arteries.
  • Cardiovascular magnetic resonance imaging (CMR) confirmed acute myocarditis.

Findings:

  • The case demonstrates an uncommon association between acute myocarditis and coronary artery spasm.
  • CMR effectively identified acute myocarditis as the underlying etiology.
  • This presentation highlights the importance of considering myocarditis in cases of suspected myocardial infarction with normal coronary arteries.

Implications:

  • Recognizing acute myocarditis as a cause of coronary spasm is vital for guiding treatment strategies.
  • Cardiovascular magnetic resonance imaging plays a key role in diagnosing myocarditis when coronary arteries appear normal.
  • This case underscores the need for comprehensive diagnostic approaches in patients with unexplained ST-segment elevation myocardial infarction.

Keywords:
Acute coronary syndromeCoronary spasmMyocardial infarctionMyocarditis

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