Article Sidebar
Main Article Content
Abstract
Acute myocarditis is a major differential diagnosis of acute coronary syndrome (ACS), particularly in young patients. We report the case of a 38-year-old obese man admitted for constrictive chest pain with inferior ST-segment elevation and a massive troponin elevation (4953 ng/L). Due to the absence of necrosis on ECG and a flu-like context, the ACS diagnosis was reassessed. Coronary angiography was normal, ruling out obstructive artery disease. Cardiac MRI confirmed acute myocarditis, showing subepicardial late gadolinium enhancement and edema. This case highlights the importance of considering myocarditis in patients presenting with ACS and non-obstructive coronary arteries, especially when access to MRI, the key diagnostic tool, is limited.
Keywords
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
- RÉFÉRENCES
- 1. Soumah MM, Kanikomo D, Ndiaye M, Sow ML. La mort subite de l'adulte, particularités en Afrique, à propos de 476 cas [The sudden death of adult, particularities in Africa: about 476 cases]. Pan Afr Med J. 2013; 16:125.
- 2. Monney P, Locca D, Muzzarelli S, Hullin R, Jeanrenaud X, Schwitter J. IRM cardiaque : imagerie de référence dans le diagnostic des myocardites aigues ? Rev med suisse 2012 ; 8 : 1177- 83.
- 3. Ibanez B, James S, Agewall S, et al (2018) Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society. Eur Heart J 39:119–77
- 4. Testani J, Kolansky DM, Litt H, et al (2006) Focal myocarditis mimicking acute ST-elevation myocardial infarction. Tex HeartInst J 33:256–9
- 5. Combes A, Luyt CE, Trouillet JL (2005) Myocardites aiguës. Réanimation14:248–54
- 6. Smith SC, Ladenson JH, Mason JW, et al. Élévations de la troponine I cardiaque associées à la myocardite. Corrélations expérimentales et cliniques. Circulation 1997;95:163-8. 10.1161/01.CIR.95.1.163 [ DOI ] [ PubMed ] [ Google Scholar ].
- 7. Kobayashi D.,Aggarwal S., Kheiwa A., et al. Yopericardite chez l’enfant. Un taux élevé de troponine I ne prédit pas l’évolution pediatr cardiol 20212 ; 33 : 1040-5.
- 8. Nozari Y, Tadjini M, Mehrani M (2016) Focal myopericarditis as a rare but important differential diagnosis of myocardial infarction; acase series. Emerg (Tehran) 4:3.
References
RÉFÉRENCES
1. Soumah MM, Kanikomo D, Ndiaye M, Sow ML. La mort subite de l'adulte, particularités en Afrique, à propos de 476 cas [The sudden death of adult, particularities in Africa: about 476 cases]. Pan Afr Med J. 2013; 16:125.
2. Monney P, Locca D, Muzzarelli S, Hullin R, Jeanrenaud X, Schwitter J. IRM cardiaque : imagerie de référence dans le diagnostic des myocardites aigues ? Rev med suisse 2012 ; 8 : 1177- 83.
3. Ibanez B, James S, Agewall S, et al (2018) Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society. Eur Heart J 39:119–77
4. Testani J, Kolansky DM, Litt H, et al (2006) Focal myocarditis mimicking acute ST-elevation myocardial infarction. Tex HeartInst J 33:256–9
5. Combes A, Luyt CE, Trouillet JL (2005) Myocardites aiguës. Réanimation14:248–54
6. Smith SC, Ladenson JH, Mason JW, et al. Élévations de la troponine I cardiaque associées à la myocardite. Corrélations expérimentales et cliniques. Circulation 1997;95:163-8. 10.1161/01.CIR.95.1.163 [ DOI ] [ PubMed ] [ Google Scholar ].
7. Kobayashi D.,Aggarwal S., Kheiwa A., et al. Yopericardite chez l’enfant. Un taux élevé de troponine I ne prédit pas l’évolution pediatr cardiol 20212 ; 33 : 1040-5.
8. Nozari Y, Tadjini M, Mehrani M (2016) Focal myopericarditis as a rare but important differential diagnosis of myocardial infarction; acase series. Emerg (Tehran) 4:3.