Why the study?
Myocarditis can mimic ST-elevation myocardial infarction, and misdiagnosis can lead to unnecessary or harmful interventions such as thrombolysis or coronary angiography.
Myocarditis should be considered in the differential diagnosis of patients presenting with ST-segment elevation to avoid unnecessary and potentially harmful interventions.
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May avert unnecessary angiography by considering myocarditis in STEMI presentations; leaves open validated diagnostic algorithms.
When evaluating a patient with ST-segment elevation on ECG and acute chest pain, providers often rapidly arrive at the diagnosis of ST-elevation myocardial infarction (STEMI). As myocardial infarction is deadly and time is of the essence in establishing reperfusion, it is reasonable to place it at the top of the differential. However, doing so should not come at the expense of conducting a thorough clinical evaluation, considering all causes of ST-segment elevation, and creating a comprehensive differential. Myocarditis, in particular, can present similarly to myocardial infarction and misdiagnosis can lead to unnecessary and sometimes harmful interventions such as thrombolytic therapy, vasodilator therapy, or coronary angiography. We present a case of myocarditis mimicking STEMI and discuss diagnosis and treatment of myocarditis.
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Hussain et al. (2023) studied this question.
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