Key result
A 21-year-old male presenting with STEMI-like symptoms was diagnosed with fulminant acute myocarditis complicated by severe coronary vasospasm and cardiogenic shock, which resolved with supportive care.
Why the study?
The association of coronary vasospasm and acute fulminant myocarditis is a rare clinical situation in young patients with persistent ST elevation.
Case Report (n=1)
No
Acute fulminant myocarditis can rarely present with severe coronary vasospasm mimicking STEMI and rapidly progress to cardiogenic shock, highlighting the need for individualized diagnostic approaches.
Answers are grounded in this paper and cite their sources.
Clinicians should consider myocarditis in young STEMI-like shock; single case leaves open optimal diagnostic strategies.
Although acute myocarditis and coronary vasospasm are common differential diagnoses in the case of young patients with persistent ST elevation, the association of coronary vasospasm and acute fulminant myocarditis is a rare situation 1,2,3 . We present the case of a 21 year-old male who presented with chest pain, ECG changes and biomarker levels initially interpreted as ST elevation myocardial infarction (STEMI), in which severe coronary vasospasm was identified. Shortly after, he developed cardiogenic shock and fulminant acute myocarditis was suspected.
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Galrinho et al. (2021) conducted a case report in Fulminant acute myocarditis and coronary vasospasm (n=1). Supportive care and medical therapy was evaluated. A 21-year-old male presenting with STEMI-like symptoms was diagnosed with fulminant acute myocarditis complicated by severe coronary vasospasm and cardiogenic shock, which resolved with supportive care.
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