Electrocardiographic changes of myocarditis can mimic acute transmural infarction, highlighting the potential need for cardiac catheterization prior to thrombolytic therapy in suspected cases.
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ECG mimicry by myocarditis warrants thrombolysis caution; leaves open catheterization role in ambiguous acute presentations.
A patient with cardiogenic shock had typical electrocardiographic findings of acute anterior transmural myocardial infarction. Cardiac catheterization revealed normal coronary arteries and severe biventricular failure. Postmortem examination confirmed normal coronary arteries; acute myocarditis, but no evidence for infarction, was found. Electrocardiographic changes of myocarditis may be indistinguishable from acute transmural infarction. In suspected cases, cardiac catheterization should be considered prior to thrombolytic therapy.
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Chakko et al. (1990) studied this question.
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