Myopericarditis--diagnostic dilemmas in relation to acute myocardial infarction

Abstract

INTRODUCTION: Myopericarditis with clinical presentation of chest pain, electrocardiographic changes and positive cardio specific enzymes is often a differential diagnostic dilemma in relation to acute myocardial infarction. Literature data are very scarce and only case reports or small series of patients can be found in the literature so each case is a significant contribution to this issue.CASE REPORT: A 19-year-old patient was admitted to the intensive care unit, with chest pain, electrocardiographic signs of suspected myocardial lesion and highly positive cardio specific enzymes. Since echocardiography revealed segmental hypocinesia of the left ventricle, urgent coronary angiography was done, which diagnosed normal luminogram of coronary arteries. Having received the adequate therapy, the patient was subjectively asymptomatic, hemodynamically stable, sub-febrile at the beginning of hospitalization. Two weeks after admission, the patient was discharged in good condition with diagnosis of myopericarditis.CONCLUSION: This case shows that it is sometimes difficult to differentiate acute miopericarditis from acute myocardial infarction only according to anamnesis, clinical, electrocardiographic sings and echocardiography.