Cardiac magnetic resonance imaging successfully identified acute myocarditis in a 40-year-old man presenting with symptoms and signs mimicking a non-ST segment elevation myocardial infarction.
Case Report (n=1)
No
Acute myocarditis can present with clinical, electrocardiographic, and biomarker findings that closely mimic acute coronary syndrome, highlighting the importance of multimodality imaging like cardiac MRI for accurate diagnosis.
Abstract Introduction : The association between ST segment abnormalities, elevated cardiac enzymes, and chest pain is usually a marker of acute coronary injury. However, certain other pathologies can sometimes mimic acute coronary syndromes. Case report : A 40-year-old Caucasian male, former smoker, with no other cardiovascular risk factors, presented to the Emergency Department for typical ischemic, prolonged chest pain. The ECG demonstrated inverted T waves in leads I, II, aVL, and V3 to V6. The patient presented high cardiac necrosis markers (troponin I 2.65 ng/ml). Based on these findings, the case was interpreted as non-ST segment elevation myocardial infarction, but coronary angiography excluded the presence of significant coronary lesions. The ventriculography showed an efficient left ventricle, with mild hypokinesia of the two apical thirds of the anterior left ventricular wall. Cardiac magnetic resonance imaging demonstrated areas of hypersignal on the T2-weighted imaging sequence in the left ventricular myocardium, suggestive for acute myocarditis. The patient was started on antiplatelet, beta-blocker, and angiotensin converting enzyme inhibitor, with favorable evolution. Conclusion : This case underlines the polymorphic appearance of acute myocarditis, which can often mimic an acute coronary event.
Pintilie et al. (Thu,) conducted a case report in Acute myocarditis (n=1). Cardiac magnetic resonance imaging (CMRI) was evaluated on Diagnosis of acute myocarditis. Cardiac magnetic resonance imaging successfully identified acute myocarditis in a 40-year-old man presenting with symptoms and signs mimicking a non-ST segment elevation myocardial infarction.