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Recurrent Myocarditis Imitating ST Segment Elevation Myocardial Infarction.

Anthony E Peters1, Adrian Loffler2,3, Christopher M Kramer2,3

  • 1Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA.

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|March 26, 2019
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Summary
This summary is machine-generated.

Recurrent acute myocarditis is rare but can progress. This case highlights a young man experiencing three episodes of myocarditis over three months, with imaging showing worsening inflammation.

Keywords:
Cardiovascular magnetic resonance imagingLate gadolinium enhancementMyocarditisT1 and T2 mapping

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Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Pathology

Background:

  • Acute myocarditis can mimic ST-segment elevation myocardial infarction.
  • Recurrence and disease progression in myocarditis are uncommon but possible.

Purpose of the Study:

  • To report a rare case of recurrent and progressive acute myocarditis.
  • To illustrate the diagnostic utility of cardiovascular magnetic resonance imaging (CMR) in assessing disease progression.

Main Methods:

  • Case report of a 29-year-old male patient.
  • Clinical presentation with recurrent chest pain.
  • Serial cardiovascular magnetic resonance imaging (CMR) to evaluate myocardial inflammation and progression.

Main Results:

  • The patient experienced three distinct episodes of acute myocarditis within a 3-month period.
  • Cardiovascular magnetic resonance imaging (CMR) demonstrated progressive, patchy myocardial inflammation over the course of the episodes.
  • The findings suggest a rare, relapsing-remitting course with documented progression of cardiac inflammation.

Conclusions:

  • Recurrent and progressive acute myocarditis, though rare, should be considered in cases with repeated cardiac events.
  • Serial CMR is valuable for monitoring disease activity and progression in myocarditis.
  • This case underscores the importance of comprehensive evaluation and follow-up in managing complex myocarditis presentations.