Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Summer;4(3):159-62.

Focal Myopericarditis as a Rare but Important Differential Diagnosis of Myocardial Infarction; a Case Series

Younes Nozari  1 , Masih Tajdini  1 , Mehdi Mehrani  1 , Rosa Ghaderpanah  1
Affiliations

Focal Myopericarditis as a Rare but Important Differential Diagnosis of Myocardial Infarction; a Case Series

Younes Nozari et al. Emerg (Tehran). 2016 Summer.

Abstract

Distinguishing ST-elevation myocardial infarction (STEMI) differential diagnoses is more challenging. Myopericarditis is one of these differentials that results from viral involvement of myocardium and pericardium of the heart. Myopericarditis in focal form can mimic acute STEMI in its electrocardiogram (ECG) features and elevated cardiac enzymes. Myocarditis patients may face thrombolytic related complications such as intracranial bleeding, myocardial rupture, and hemorrhagic cardiac tamponade. Furthermore, re-administration of streptokinase (a common thrombolytic agent in our country) is banned for at least six months of previous administration; however, it can save patients' lives in emergency conditions such as massive pulmonary embolism. It seems that, when dealing with a young patient presenting to emergency department with acute chest pain and ST segment elevation on ECG, we should consider focal myocarditis as an important but rare differential diagnosis of STEMI. In this report, we describe three cases of focal myocarditis, primarily misdiagnosed as STEMI.

Keywords: Coronary angiography; electrocardiography; emergency medicine; myocardial infarction; myocarditis.

PubMed Disclaimer

Figures

Figure 1
Figure 1
12-leads electrocardiogram of reported patients
See this image and copyright information in PMC

References

    1. Tajdini M. Spontaneous myopericarditis in a patient under dexamethasone: A double-edged sword? Journal of the Saudi Heart Association. 2015;27(4):292–4. - PMC - PubMed
    1. Testani JM, Kolansky DM, Litt H, Gerstenfeld EP. Focal Myocarditis Mimicking Acute ST-Elevation Myocardial Infarction. Texas Heart Institute Journal. 2006;33(2) - PMC - PubMed
    1. Chow LH, Radio SJ, Sears TD, Mcmanus BM. Insensitivity of right ventricular endomyocardial biopsy in the diagnosis of myocarditis. Journal of the American College of Cardiology. 1989;14(4):915–20. - PubMed
    1. Deckers JW, Hare JM, Baughman KL. Complications of transvenous right ventricular endomyocardial biopsy in adult patients with cardiomyopathy: a seven-year survey of 546 consecutive diagnostic procedures in a tertiary referral center. Journal of the American College of Cardiology. 1992;19(1):43–7. - PubMed
    1. Gahide G, Bertrand D, Roubille F, Tron C, Skaik S, Piot C, et al. MR delayed enhancement imaging findings in suspected acute myocarditis. European radiology. 2010;20(1):65–72. - PubMed

LinkOut - more resources