Analysis of One Patient with Myocarditis Mimicking Acute septilateral Myocardial Infarction

YE Cheng

doi:10.3969/j.issn.1002-3429.2016.12.001

Abstract：Objective To investigate clinical features of acute myocarditis in order to decrease misdiagnosis and mis-treatment. Methods Clinical data of one acute myocarditis patient misdiagnosed as having septilateral myocardial infarction was retrospectively analyzed. Results The patient visited a doctor for dyspnea and chest pain for one day, and was suspected history of cold a week ago, and then increasing blood leukocyte, neutrophil cells, cardiac troponin I and myocardial enzyme spectrum were found by urgent examination after admission. Electrocardiogram examination ( ECG) showed that I, avL and V3 -6 leads ST segment were raised. Conditions of emergency coronary angiography for coronary artery were lack, and thrombo-lytic therapy with urokinase was performed within 1 h admission for septilateral myocardial infarction. No significant improve-ment in ECG was found between the time of admission and after thrombolysis. The ultrasound cardiogram ( UCG) examination showed no obvious abnormalities, and pericardial effusion was excluded, and acute myocarditis was suspected. Symptomatic treatments such as myocardium nutrition, oxygen inhalation and anti-viral were given, Coronary CT angiography 2 weeks later showed normal excepted for a high origin of left coronary artery, and the patient was discharged after conditions were im-proved. ECG by follow-up six months later showed that I, avL and V3-6 leads T wave inversion without other symptoms. Con-clusion Clinical manifestations of myocarditis are various, but the reports about acute myocarditis mimicking septilateral my-ocardial infarction are lack. It is the key to avoid misdiagnosis and mistreatment by improving understanding performing related examinations .