Focal Myopericarditis As a Rare But Important Differential Diagnosis of Myocardial Infarction; a Case Series



Nozari Y¹ ; Tajdini M¹ ; Mehrani M¹ ; Ghaderpanah R¹ Show Affiliations
Source: Emergency Published:2016

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. Myopericarditis in focal form can mimic electrocardiogram (ECG) features of acute STEMI and elevate 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. © (2016) Shahid Beheshti University of Medical Sciences.