ST Elevations and Elevated Cardiac Enzymes Not Always a STEMI: Two Case Reports
Insights
This case report highlights how careful electrocardiogram evaluation and risk assessment can differentiate ST elevation myocardial infarction (STEMI) from myocarditis in emergency department patients with chest pain and elevated cardiac enzymes.
Area of Science:
- Cardiology
- Emergency Medicine
- Diagnostic Imaging
Background:
- Chest pain is a frequent emergency department (ED) presentation.
- ST elevation and elevated cardiac enzymes suggest ST elevation myocardial infarction (STEMI) or myocarditis.
- Accurate differentiation is crucial for appropriate patient management.
Abstract:
Chest pain is a common complaint in the emergency department (ED). Besides a careful history and physical exam; electrocardiogram, laboratory tests and imaging studies are widely available diagnostic tests that are used for patient assessment. When ST elevation and elevated cardiac enzymes are present the most likely diagnosis are ST elevation myocardial infarction (STEMI) or myocarditis. In this case report we present two low risk patients for major adverse cardiac event with ST elevation and elevated cardiac enzymes and how a careful risk assessment and detailed electrocardiogram evaluation could help differentiating between these two diagnoses.
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