Myocarditis in patients with clinical presentation of myocardial infarction and normal coronary angiograms

Abstract

Among 45 patients presenting with acute MI and normal coronary angiograms, 38% had diffuse myocarditis and 40% had a scintigraphic pattern of heterogeneous or focal myocarditis. Short-term follow-up showed complete LV functional recovery in 81% of these patients.

Myocarditis

“…9,71 Segmental or global echocardiographic wall motion abnormalities are frequently evident despite angiographically normal coronary anatomy. 71 Sarda et al, 72 using myocardial indium 111 -labeled antimyosin antibody and rest thallium imaging, identified 35 of 45 patients (78%) who presented with acute chest pain, ischemic ECG abnormalities, and elevated cardiac biomarkers as having myocarditis. However, biopsy verification of actual myocarditis was not undertaken in this series.…”

Recognition of the Apical Ballooning Syndrome in the United States

“…3,5 Acute lymphocytic myocarditis may also mimic acute myocardial infarction, with ECG changes that extend beyond a single coronary arterial territory, marked segmental wall motion abnormalities that resolve rapidly, and mild-to-modest biomarker evidence for myocardial necrosis. 10,11 However, the unique apical ballooning pattern of segmental dysfunction has not been described in biopsy-proven cases of myocarditis. Furthermore, endomyocardial biopsy, when performed in a limited number of cases, has uniformly failed to demonstrate histopathological evidence for myocarditis.…”

Fulminant myocarditis complicated with cardiac arrest and subsequent acute respiratory distress syndrome formation rescued by Extracorporeal Membrane Oxygenation – A rare case report

“…The electrocardiographic findings are often variable [3,4] . It can frequently mimic AMI [3,5,6] and most of these cases were reported to have normal coronary arteries [5,6] and long-term prognosis is generally good [3] . However, AFM is a life-threatening medical emergency and mortality was extremely high without immediate and adequate treatment [1] .…”