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Cardiogenic shock presenting in myocardial infarction with myocarditis case report: The role of advanced

Mochamad Yusuf Alsagaff1,2, Putu Dwipa Krisna Devi1, Christian Pramudita Budianto1

  • 1Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Hospital, Surabaya, Indonesia.

SAGE Open Medical Case Reports
|October 27, 2023
PubMed

Insights

Myocarditis presents with chest pain and dyspnea, mimicking myocardial infarction. Echocardiography, particularly strain imaging, aids in diagnosing myocarditis, leading to successful treatment and recovery.

Area of Science:

  • Cardiology
  • Medical Diagnostics

Background:

  • Myocarditis symptoms like chest pain and dyspnea overlap with myocardial infarction, complicating diagnosis.
  • Electrocardiographic changes in myocarditis can resemble myocardial infarction, but coronary angiography often shows normal findings.
  • Accurate diagnosis is challenging, risking misdiagnosis as myocardial infarction with nonobstructive coronary arteries.

Observation:

  • A 40-year-old man presented with chest pain and dyspnea, initially diagnosed as ST-elevation myocardial infarction (STEMI) with cardiogenic shock.
  • Coronary angiography revealed no significant coronary artery obstruction.
  • Bedside echocardiography and serial left ventricle global longitudinal strain measurements supported a myocarditis diagnosis.

Findings:

  • Two-dimensional speckle tracking echocardiography precisely evaluated left ventricle (LV) global and regional dysfunction.
  • Serial left ventricle global longitudinal strain measurements were crucial in differentiating myocarditis from myocardial infarction.
  • The patient recovered fully within 7 days after receiving myocarditis treatment.

Implications:

  • This case highlights the utility of echocardiography, especially strain imaging, in diagnosing myocarditis.
  • Early and accurate diagnosis of myocarditis can prevent unnecessary interventions for suspected myocardial infarction.
  • Prompt treatment of myocarditis leads to favorable patient outcomes and complete recovery.

Keywords:
MINOCAMyocarditisechocardiography

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