This case report highlights the diagnostic challenge of differentiating between MINOCA and myocarditis in a young male presenting with acute chest pain, ST-segment elevation, and significantly elevated troponin.
CMR may differentiate myocarditis from MINOCA in select cases; leaves open need for validated diagnostic algorithms.
Myocardial infarction with non-obstructive coronary arteries (MINOCA) has been defined as clinical presentation of an acute coronary syndrome with laboratory evidence of myocardial necrosis, but with coronary stenosis of less than 50% on coronary angiography. On the other side, myocarditis is an inflammatory response triggered by viral, bacterial, fungal, lymphocytic, eosinophilic, or autoimmune myocardial injury, which may be associated with elevated myocardial necrosis serum biomarkers. We present the case of a young male patient with acute chest pain, ST-segment elevation, and high-sensitivity troponin levels of 22,162 ng/L.
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Libenciuc et al. (2020) studied this question.
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