ACUTE MYOCARDITIS IN YOUNG AGE MIMICKING AS ST-ELEVATION MYOCARDIAL INFARCTION: CASE REPORT
A Kyrychenko1, N Tomakh1, V Kornatsky2
11State Institution "Ukrainian State Research Institute of Medical and Social Ddisability Problems of the Ministry of Health of Ukraine", Ukraine.
Insights
Acute myocarditis can mimic heart attacks, posing diagnostic challenges. This case shows how inflammatory markers and cardiac MRI confirm myocarditis, differentiating it from myocardial infarction with non-obstructed coronary arteries (MINOCA).
Area of Science:
- Cardiology
- Diagnostic Imaging
- Biomarkers
Background:
- Acute myocarditis presents diverse symptoms, often mimicking ST-elevation myocardial infarction (STEMI).
- Accurate diagnosis is crucial for appropriate patient management and outcomes.
Observation:
- A 26-year-old male presented with chest pain, elevated troponin, ST-segment elevations, and reduced ejection fraction, initially suggesting STEMI.
- Coronary angiography revealed non-obstructed coronary arteries (MINOCA).
Findings:
- Positive serial troponin tests and elevated inflammatory markers raised suspicion for myocarditis.
- Cardiac MRI definitively confirmed the diagnosis of acute myocarditis.
Implications:
- This case underscores the importance of considering myocarditis in STEMI-like presentations.
- Integrating laboratory markers and cardiac MRI is vital for accurate myocarditis diagnosis.
- Early and correct diagnosis of myocarditis can prevent unnecessary interventions for myocardial infarction.
Abstract:
Acute myocarditis remains a diagnostic issue with a wide spectrum of clinical manifestations that could mimic ST-elevation myocardial infarction (STEMI). We present a case of a 26-year-old male with left-sided intense squeezing chest pain associated with elevated troponin, ST-segment elevations, and reduced ejection fraction. The patient was initially suspected of having a STEMI with non-obstructed coronary arteries (MINOCA). However, due to positive pair troponin tests, increased inflammatory markers there was suspected myocarditis and cardiac MRI confirmed this diagnosis. This case highlights the clinical significance of assessment of laboratory markers and cardiac MRI in diagnostics of myocarditis.
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