Acute Myocarditis as Myocardial Infarction Mimic: Presentation of Case and Review of Literature

Chest pain is a common symptom that results in visits to the emergency department. When it occurs, family members become worried because of the association between chest pain and cardiac disease. Although chest pain is rarely associated with serious diseases, failure to perform a timely diagnosis may result in fatalities. This is a report on a 13-year-old obese boy who initially presented with abdominal pain and diarrhea and who subsequently complained of progressive chest pain that eventually radiated to the left arm. Initial diagnostic tests showed ST segment elevations and elevated CKMB and troponin I. He was initially managed as myocardial infarction. A 2-dimensional echocardiogram showed a low ventricular ejection fraction. Monitoring of the electrocardiogram and the cardiac enzymes showed rapid reversal of the previously seen abnormal findings, which is atypical of the course of myocardial infarction. The history, physical examination, and diagnostic findings fulfilled the criteria for acute myocarditis.