Acute Myoperidarditis with Focal ECG Findings Mimicking Acute Myocardial Infarction

Nisbet, Bruce C.; Breyer, Michael

doi:10.1016/j.jemermed.2008.01.013

Cited by 24 publications

(22 citation statements)

References 14 publications

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“…When observed only in the apical myocardial segments, as in our case, wall motion abnormalities may be indicative of focal myocarditis. ECG abnormalities associated with myocarditis may initially mimic ST-elevation or non-ST-elevation acute myocardial infarction [17] . However, considering how ST-T abnormalities evolve in the course of time, the ECG changes associated with acute myocarditis evolve much slower than those seen with acute myocardial infarction [18] .…”

Section: Discussionmentioning

confidence: 99%

A Patient with Suspected Myocarditis Associated with Legionnaires' Disease: A Case Report and Review of the Literature

Erdoğan¹,

Eldem²

2018

mjima

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Legionnaires' disease (LD) is a systemic infectious disease caused by Legionella species. It mainly presents with lung involvement. Herein, we present a case with suspected myocarditis associated with LD and review of the relevant literature. An 81-year-old male tourist patient with high fever, cough, imbalance while walking, and confusion presented to the emergency department. The patient was diagnosed with LD based on increased density in the left lower zone on chest x-ray and a positive Legionella urine antigen test. He was administered a combination of claritromycin and levofloxacine on the day of admission. The diagnosis of acute myocarditis was made after worsening of the cardiac functions, ST elevation and troponin I positivity. The patient's symptoms regressed with antibiotic therapy and the patient was transferred to his home country by ambulance plane ten days after admission. A search of PubMed and Web of Science using the keywords "Legionella and myocarditis" revealed 15 case reports, nine of which were in English and were reviewed. There were three female and six male patients with a mean age of 44 years (range: 32-56 years). Seven were diagnosed with LD by urine antigen testing, one by serological testing and culture, and one by direct fluorescent-antibody staining and culture. Myocarditis was diagnosed by biopsy in two patients and by clinical and laboratory findings in the rest. Myocarditis without existing pneumonia was detected in one case. Electrocardiography abnormalities such as atrial flutter, atrioventricular block, torsade de pointes, sinus tachycardia, QT prolongation, ST elevation, and T wave inversion were detected in seven patients. Ventricle dysfunction on echocardiography and cardiac marker abnormality were detected in all but one of the patients (not tested in one patient). Antimicrobial monotherapy was chosen for three of the cases. One patient died due to myocarditis. In conclusion, myocarditis may develop rarely during the course of LD. Clinical suspicion is essential for the diagnosis. Early diagnosis and appropriate treatment may be life-saving. Keywords: Pneumonia, Legionella pneumophila, Legionnaires' disease, myocarditis, travel medicine Lejyoner hastalığı (LH), Legionella bakterisinin etkeni olduğu ve ön planda akciğerlerin tutulduğu sistemik bir enfeksiyon hastalığıdır. Burada LH tanısı alan ve miyokardit şüphesi olan bir olgu sunuldu ve ilgili literatür gözden geçirildi. Seksen bir yaşında turist erkek hasta yüksek ateş, öksürük, yürümede bozukluk ve bilinç değişikliği şikayeti ile acil servise başvurdu. Akciğer grafisinde sol alt zonda dansite artışı ve idrarda Legionella antijeni olumlu saptanması üzerine LH tanısı aldı. Klaritromisin ve levofloksasin tedavisine yattığı gün başlandı. Kardiyak fonksiyonların kötüleşmesi, ST elavasyonu ve troponin I değerlerinde yükseklik akut miyokardit ile uyumlu bulundu. Antibiyotik tedavisi ile şikayetleri gerileyen hasta kendi isteği üzerine yatışının onuncu günü uçak ambulansla ülkesine gönderildi. PubMed ve Web of Sciences...

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Section: Discussionmentioning

confidence: 99%

A Patient with Suspected Myocarditis Associated with Legionnaires' Disease: A Case Report and Review of the Literature

Erdoğan¹,

Eldem²

2018

mjima

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“…Although biopsy is the main technique used for the diagnosis of myocarditis, it may be of limited clinical value in certain cases, particularly in myopericarditis, where pericardial involvement is prevalent. In the 11 identified cases of acute myopericarditis mimicking AMI (9-18), endomyocardial biopsy of the right ventricle was only performed in 1 case, and the results demonstrated a number of the expected histological features of myocarditis, including endomyocardial fibrosis, myocytolytic changes and interstitial edema (14).…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the differentiation of acute myopericarditis from AMI is of great importance due to differences in the complications, treatment strategies and prognoses between the two conditions. A large number of studies have investigated the differentiation between acute myopericarditis and AMI since 2008 (6,(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). However, to the best of our knowledge, acute myopericarditis resulting from M. tuberculosis infection and simulating AMI has not previously been reported.…”

Section: Introductionmentioning

confidence: 99%

Acute tuberculous myopericarditis mimicking acute myocardial infarction: A case report and literature review

Ren

Zhang

et al. 2016

Experimental and Therapeutic Medicine

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Abstract.A number of cases of acute myopericarditis mimicking acute myocardial infarction (AMI) have previously been reported in the literature. However, to the best of our knowledge, such a case resulting from Mycobacterium tuberculosis infection has not previously been described. The present study reports the case of a 21-year-old male patient presenting with acute chest pain, in whom focal ST-segment elevation and elevated cardiac enzymes mimicked a diagnosis of AMI. However, acute tuberculous myopericarditis was diagnosed on the basis of a variety of imaging examinations, laboratory tests, as well as the changes observed in electrocardiograms (ECGs) and in the cardiac enzyme levels. The case highlights the importance of a detailed collection of medical history, comprehensive explanations of serial ECGs, thoracic computed tomography, echocardiogram and coronary angiography in the diagnosis and differentiation of acute tuberculous myopericarditis mimicking AMI.

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“…Des Weiteren sind Bradykardien mit AV-Blockierung (22 %), Repolarisationsstörungen (32-60 %), Veränderungen der elektrischen Herzachse (53 %) und Zeichen der ventrikulären Hypertrophie (46 %) möglich [16,21]. Infarktzeichen, Niedervoltage, P-Wellen-Veränderungen sowie die typischen Zeichen einer begleitenden Perikarditis können ebenfalls vorliegen [16,17,22]. Verdachtsmomente vor allem i. S. von Herzrhythmusstörungen können durch das Langzeit-EKG evaluiert oder bestätigt werden.…”

Section: Elektrokardiogramm (Ekg)unclassified

Myokarditis im Kindes- und Jugendalter

Schubert¹,

Messroghli²,

Klaassen³

et al. 2017

Kardio up

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Acute Myoperidarditis with Focal ECG Findings Mimicking Acute Myocardial Infarction

Cited by 24 publications

References 14 publications

A Patient with Suspected Myocarditis Associated with Legionnaires' Disease: A Case Report and Review of the Literature

A Patient with Suspected Myocarditis Associated with Legionnaires' Disease: A Case Report and Review of the Literature

Acute tuberculous myopericarditis mimicking acute myocardial infarction: A case report and literature review

Myokarditis im Kindes- und Jugendalter

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