A Confusing Presentation of Acute Chest Pain: Case Report

The resemblance between the presentations of acute myocarditis and myocardial infarction poses a great challenge regarding diagnosis and management. Materials and Methods: This study describes the case of a young man aged 25 who had acute retrosternal pain, elevated cardiac markers and electrocardiographic ST-T changes. The patient is 15 pack-year smoker and has positive history of coronary artery disease of his father and his eldest brother. The patient underwent coronary angiography, which revealed normal coronary arteries. Summary of Results: The diagnosis of myopericarditis was made on consideration of his fever, sore throat and body ache for 5 days prior to chest pain, elevated cardiac markers, electrocardiographic ST-T changes but only after the exclusion of acute coronary syndrome by a normal coronary angiogram. Conclusion and Recommendations: Myopericarditis can present with a wide variety of findings. Some of those findings are also characteristic of acute coronary syndrome. This might make the diagnosis confusing. However, even if the patient is young and the presentation is consistent with myopericarditis, still it is important to exclude the diagnosis of acute coronary syndrome by performing a coronary angiogram before settling on the diagnosis of myopericarditis.