<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>Introduction</bold>: The association between ST segment abnormalities, elevated cardiac enzymes, and chest pain is usually a marker of acute coronary injury. However, certain other pathologies can sometimes mimic acute coronary syndromes.<bold>Case report</bold>: A 40-year-old Caucasian male, former smoker, with no other cardiovascular risk factors, presented to the Emergency Department for typical ischemic, prolonged chest pain. The ECG demonstrated inverted T waves in leads I, II, aVL, and V3 to V6. The patient presented high cardiac necrosis markers (troponin I 2.65 ng/ml). Based on these findings, the case was interpreted as non-ST segment elevation myocardial infarction, but coronary angiography excluded the presence of significant coronary lesions. The ventriculography showed an efficient left ventricle, with mild hypokinesia of the two apical thirds of the anterior left ventricular wall. Cardiac magnetic resonance imaging demonstrated areas of hypersignal on the T2-weighted imaging sequence in the left ventricular myocardium, suggestive for acute myocarditis. The patient was started on antiplatelet, beta-blocker, and angiotensin converting enzyme inhibitor, with favorable evolution.<bold>Conclusion</bold>: This case underlines the polymorphic appearance of acute myocarditis, which can often mimic an acute coronary event.</abstract>

Introduction: The association between ST segment abnormalities, elevated cardiac enzymes, and chest pain is usually a marker of acute coronary injury. However, certain other pathologies can sometimes mimic acute coronary syndromes.Case report: A 40-year-old Caucasian male, former smoker, with no other cardiovascular risk factors, presented to the Emergency Department for typical ischemic, prolonged chest pain. The ECG demonstrated inverted T waves in leads I, II, aVL, and V3 to V6. The patient presented high cardiac necrosis markers (troponin I 2.65 ng/ml). Based on these findings, the case was interpreted as non-ST segment elevation myocardial infarction, but coronary angiography excluded the presence of significant coronary lesions. The ventriculography showed an efficient left ventricle, with mild hypokinesia of the two apical thirds of the anterior left ventricular wall. Cardiac magnetic resonance imaging demonstrated areas of hypersignal on the T2-weighted imaging sequence in the left ventricular myocardium, suggestive for acute myocarditis. The patient was started on antiplatelet, beta-blocker, and angiotensin converting enzyme inhibitor, with favorable evolution.Conclusion: This case underlines the polymorphic appearance of acute myocarditis, which can often mimic an acute coronary event.

To Be or Not to Be … Acute Coronary Syndrome

Emergency Institute for Cardiovascular Diseases and Transplantation, Tîrgu Mureș, Romania, University of Medicine and Pharmacy, Tîrgu Mureș,

Acta Marisiensis - Seria Medica

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

{"article-title":"To Be or Not to Be \u2026 Acute Coronary Syndrome"}

Introduction: The association between ST segment abnormalities, elevated cardiac enzymes, and chest pain is usually a marker of acute coronary injury. However,...

To Be or Not to Be … Acute Coronary Syndrome

Published Online: Oct 21, 2016

Page range: 363 - 367

Received: Feb 22, 2016

Accepted: Jun 07, 2016

DOI: https://doi.org/10.1515/amma-2016-0029

Keywords
myocarditis, acute myocardial infarction, cardiac magnetic resonance imaging

© 2016 Pintilie Irina et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

To Be or Not to Be … Acute Coronary Syndrome

Published Online: Oct 21, 2016

Page range: 363 - 367

Received: Feb 22, 2016

Accepted: Jun 07, 2016

DOI: https://doi.org/10.1515/amma-2016-0029

Keywordsmyocarditis, acute myocardial infarction, cardiac magnetic resonance imaging

© 2016 Pintilie Irina et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
myocarditis, acute myocardial infarction, cardiac magnetic resonance imaging