Suspected Tick-Borne Viral Infection-Associated Myocarditis Presenting with ST-Segment Elevation in V1-V3
Meina Piao1, Vipi Kumar2, Megumi Narisawa3
1Department of Cardiology and Hypertension, The Affiliated Hospital of Yanbian University (Yanbian Hospital), Yanji, China.
Summary
This case study details a patient with viral myocarditis mimicking a heart attack. Early diagnosis and multidisciplinary treatment led to significant symptom improvement, emphasizing the importance of considering tick-borne infections.
Area of Science:
- Cardiology
- Infectious Diseases
- Internal Medicine
Background:
- Myocarditis can present with symptoms mimicking acute myocardial infarction.
- Non-obstructive coronary arteries in the context of myocardial injury suggest alternative etiologies.
- Geographic location and endemic infections are crucial in differential diagnosis.
Purpose of the Study:
- To highlight the diagnostic challenges of viral myocarditis presenting as myocardial infarction with non-obstructive coronary arteries (MINOCA).
- To emphasize the role of tick-borne infections in the differential diagnosis of MINOCA.
- To underscore the importance of a multidisciplinary approach in managing myocarditis.
Main Methods:
- Case report of a 59-year-old male with acute chest pain, fever, and elevated cardiac biomarkers.
- Diagnostic workup included ECG, cardiac biomarkers, and coronary angiography.
- Treatment involved corticosteroids, antiviral, antibiotic, and cardioprotective therapies.
Main Results:
- Electrocardiography showed ST-segment elevation and pathological Q waves.
- Coronary angiography revealed no obstructive coronary disease.
- The patient showed substantial clinical and laboratory improvement with the prescribed treatment regimen.
Conclusions:
- Viral myocarditis can present as MINOCA, posing diagnostic challenges.
- Tick-borne infections should be considered in endemic areas.
- Multidisciplinary collaboration is vital for effective management and optimal patient outcomes.
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