[Diagnosis of suspected acute myocardial infarct in acute regional myocarditis]

Abstract

We report on 4 patients in whom acute myocardial infarction was suspected due to acute onset of chest pain and elevation of the ST-segment. Furthermore in 2 patients the echocardiography revealed regional abnormal wall motion on admission, the others later. Coronary angiography showed normal coronary arteries in all cases. The left ventricular angiogram namely demonstrated regional abnormal wall motion. 2 patients developed a slight increase of the creatine phosphokinase including the CK-MB. Only one patient mentioned a grippal infectious disease 6 weeks before. During the hospital time all patients presented one of the inflammatory signs. A demonstration of the infectious agent was not possible in any of the cases. The endomyocardial biopsy was positive in two cases, and slightly positive in one case. Sometimes regional myocarditis might imitate an acute myocardial infarction. Both, the exact anamnesis and coronary angiography are necessary. The performance of an endomyocardial biopsy is desirable.