Background: In a subset of patients, acute myocarditis (AM) may mimic acute myocardial infarction, with a similar clinical presentation characterized by chest pain, electrocardiogram (ECG) changes consistent with acute coronary syndromes (ACS), and serum markers increment. Case summary: We present two cases of infarct-like myocarditis in patients with known coronary artery disease (CAD), in which the discrepancy between transthoracic echocardiogram findings, ECG, and angiography prompted us to look beyond the simplest diagnosis. In these cases, making a prompt and correct diagnosis is pivotal to address adequate therapy and establish a correct prognosis. Discussion: The right diagnosis can avoid unnecessary coronary revascularizations and subsequent antiplatelet therapy that may be associated with an increased haemorrhagic risk. Moreover, it allows setting up guideline-directed therapy for myocarditis, proper follow-up, as well as recommending abstention from physical activity.

Case report: acute myocarditis in two patients with coronary artery disease presenting with chest pain-thinking outside the box / N. Amelotti, M. Brusamolino, M. Mapelli, M. Contini, A. Baggiano, F. Fazzari, G. Pontone, P. Agostoni. - In: EUROPEAN HEART JOURNAL. CASE REPORTS. - ISSN 2514-2119. - 8:5(2024 May 02), pp. ytae220.1-ytae220.7. [10.1093/ehjcr/ytae220]

Case report: acute myocarditis in two patients with coronary artery disease presenting with chest pain-thinking outside the box

N. Amelotti
Co-primo
;
M. Brusamolino
Co-primo
;
M. Mapelli
Secondo
;
A. Baggiano;G. Pontone
Penultimo
;
P. Agostoni
Ultimo
2024

Abstract

Background: In a subset of patients, acute myocarditis (AM) may mimic acute myocardial infarction, with a similar clinical presentation characterized by chest pain, electrocardiogram (ECG) changes consistent with acute coronary syndromes (ACS), and serum markers increment. Case summary: We present two cases of infarct-like myocarditis in patients with known coronary artery disease (CAD), in which the discrepancy between transthoracic echocardiogram findings, ECG, and angiography prompted us to look beyond the simplest diagnosis. In these cases, making a prompt and correct diagnosis is pivotal to address adequate therapy and establish a correct prognosis. Discussion: The right diagnosis can avoid unnecessary coronary revascularizations and subsequent antiplatelet therapy that may be associated with an increased haemorrhagic risk. Moreover, it allows setting up guideline-directed therapy for myocarditis, proper follow-up, as well as recommending abstention from physical activity.
Acute coronary syndrome; Cardiac magnetic resonance; Case report; Chest pain; Infarct-like myocarditis;
Settore MED/11 - Malattie dell'Apparato Cardiovascolare
2-mag-2024
26-apr-2024
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/1050709
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