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Spontaneous Dissection of a Septal Coronary Artery Mimicking Myocarditis
Mihály Károlyi1, Christian Templin2, Hatem Alkadhi1
1Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.
Insights
Acute chest pain can mimic heart conditions. This case highlights how cardiac magnetic resonance imaging can reveal coronary dissection, even when other tests appear normal, aiding diagnosis in complex cardiac presentations.
Area of Science:
- Cardiology
- Medical Imaging
- Diagnostic Medicine
Background:
- Acute chest pain and dyspnea are common symptoms necessitating evaluation for coronary artery disease.
- Initial diagnostic workup often includes echocardiography and cardiac computed tomography.
- Normal findings from these initial tests can present a diagnostic challenge.
Observation:
- A patient presented with symptoms suggestive of myocarditis.
- Initial echocardiography and cardiac computed tomography scans were unremarkable.
- The clinical presentation prompted further investigation with advanced cardiac imaging.
Findings:
- Cardiac magnetic resonance imaging (CMR) identified coronary artery dissection.
- The diagnosis of coronary dissection was made despite initial negative findings from other cardiac imaging modalities.
- This case underscores the utility of CMR in evaluating atypical cardiac presentations.
Implications:
- Advanced imaging techniques like CMR are crucial for diagnosing rare or atypical cardiovascular conditions.
- Coronary dissection should be considered in the differential diagnosis of acute chest pain, even with normal initial cardiac imaging.
- Accurate and timely diagnosis through appropriate imaging can significantly impact patient management and outcomes.
Abstract:
Acute chest pain and dyspnea often raise coronary disease suspicion. When echocardiography and cardiac computed tomography findings appear normal, alternative diagnoses should be explored. We present a case initially suggestive of myocarditis but later revealed as coronary dissection by cardiac magnetic resonance. This case emphasizes the role of advanced imaging in atypical cardiac presentations.
