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[Myocarditis mimicking myocardial infarct]
J Sztajzel1, J M Reymond, J Adamec
1Centre de cardiologie, Hôpital cantonal universitaire, Genève.
Insights
Myocarditis can mimic myocardial infarction (MI), presenting with similar symptoms and diagnostic findings. Definitive diagnosis of myocarditis is often retrospective, highlighting the importance of careful follow-up.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Myocardial infarction (MI) is a common diagnosis for acute chest pain.
- Distinguishing MI from other cardiac conditions can be challenging.
Observation:
- Three patients initially diagnosed with MI presented with chest pain, ECG changes, elevated cardiac enzymes, and regional wall motion abnormalities.
- These initial findings were consistent with acute myocardial infarction.
Findings:
- All patients' symptoms resolved, and ECGs normalized during follow-up.
- Regional wall motion abnormalities resolved in two patients and persisted in one.
- Myocarditis was the definitive diagnosis established retrospectively in all three cases.
Implications:
- Myocarditis can present as a diagnostic mimic of myocardial infarction.
- Retrospective diagnosis is often necessary for myocarditis.
- Clinical vigilance and follow-up are crucial for accurate cardiac diagnoses.
Abstract:
We describe 3 patients with an initial diagnosis of myocardial infarction, in whom a definitive diagnosis of myocarditis was subsequently established. All had precordial chest pain, electrocardiographic changes, elevated cardiac enzyme levels and regional wall motion abnormalities of the left ventricle compatible with myocardial infarction. During follow-up, all symptoms subsided and electrocardiographic tracings normalized. Regional wall motion abnormalities disappeared in two and persisted in one patient. These findings show that myocarditis may mimic myocardial infarction, and that the definitive diagnosis is generally established retrospectively.