A 57-year-old woman presenting with pseudo-STEMI was diagnosed with purulent pericarditis and tamponade, treated with pericardiocentesis draining 600 mL of MSSA-positive purulent fluid.
Case Report (n=1)
Purulent pericarditis can present as a 'pseudo-STEMI', highlighting the importance of considering alternative diagnoses when coronary angiography reveals nonobstructive disease.
BACKGROUND: Purulent pericarditis is a rare, life-threatening condition accounting for <1% of pericardial disease. CASE SUMMARY: A 57-year-old woman with active intravenous drug use and poorly controlled type 2 diabetes presented with chest pain and inferolateral ST-segment elevations. Emergent coronary angiography revealed nonobstructive coronary artery disease. Subsequent echocardiogram revealed a large pericardial effusion with tamponade physiology. Pericardiocentesis drained 600 mL of purulent fluid positive for methicillin-sensitive Staphylococcus aureus. DISCUSSION: This case illustrates the diagnostic challenge of "pseudo-STEMI" in the setting of purulent pericarditis and underscores the importance of a rigorous diagnostic approach when angiography fails to identify a culprit lesion, necessitating a broader differential to determine the true underlying pathology.
Zarghami et al. (Fri,) conducted a case report in Purulent pericarditis (n=1). Pericardiocentesis was evaluated. A 57-year-old woman presenting with pseudo-STEMI was diagnosed with purulent pericarditis and tamponade, treated with pericardiocentesis draining 600 mL of MSSA-positive purulent fluid.