Acute myocarditis mimicking myocardial infarction can misdirect the diagnostic approach

Yıldırım, Erkan; Buğan, Barış; Köklü, Mustafa; Görmel, Suat; Çelik, Murat

doi:10.1016/j.ijcac.2016.01.005

Cited by 4 publications

(4 citation statements)

References 7 publications

(7 reference statements)

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“…According to a case series study of 34 cases of myocarditis by Dec et al, only two cases had ST depression [ 1 ]. Focal STE with reciprocal changes as reported by Yildirim et al [ 4 ], STE in an adolescent male reported by Sharma et al [ 6 ], and STE in the inferior leads in a 15-year-old male as reported by Nisbet et al [ 9 ] highlight the pattern of EKG changes in this condition. Sharif et al compared two cases with a similar clinical presentation with STE, but one with normal coronary anatomy and myopericarditis on CMRI and the other with 90% LAD occlusion [ 10 ].…”

Section: Discussionmentioning

confidence: 65%

Incidental Intramyocardial Bridging in a Myocarditis Patient Presenting With Focal ST Segment Depressions

Gupta¹,

Batool²,

Hashmi³

et al. 2020

Cureus

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Myopericarditis is an entity known to present with typical symptoms of viral prodrome and diffuse ST elevation (STE) and/or PR depressions on electrocardiogram (EKG). Atypical presentations of myocarditis such as focal STE have been cited in the literature, reflecting true coronary ischemia. However, myocarditis or pericarditis presenting with focal ST depressions is rarely seen. Myocarditis is usually overlooked as a differential for ST depressions seen on EKGs; hence, the case we present in this report highlights the importance of nonischemic causes presenting as ischemic changes on EKG. This case is unique as we have postulated a possible explanation for this finding. This report discusses the case of a young patient with myopericarditis presenting with focal ST depressions. This patient was also incidentally found to have intramyocardial bridging, usually a benign finding, on cardiac catheterization (which is shown in the case report). Our hypothesis is that the inflammation due to myocarditis in this patient led to inflammation of intramyocardial vessels, presenting as ST depressions. Since intramyocardial bridging is a common anomaly, we propose the question as to whether this could be a risk factor for sudden cardiac death and if it depends on the characteristic of the intramyocardial vessel. We would like to emphasize on the atypical presentations of this usual condition, a possible explanation for this finding, and the need for further testing for risk stratification in patients with this anomaly.

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Section: Discussionmentioning

confidence: 65%

Incidental Intramyocardial Bridging in a Myocarditis Patient Presenting With Focal ST Segment Depressions

Gupta¹,

Batool²,

Hashmi³

et al. 2020

Cureus

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“…Despite compounding evidence establishing a possible causal relationship between COVID-19 infection and ACS, there are currently no sufficient data to categorically state that the advent of ACS observed among this subset of patients is due to an underlying medical condition or as a result of a direct cardiac effect of the virus itself. The overlapping laboratory evidence such as troponin I and clinical features of chest pain and dyspnea seen in both cases of myocarditis and myocardial infarction can also pose as a limiting factor in diagnosis [ 31 , 32 ].…”

Section: Reviewmentioning

confidence: 99%

COVID-19 and Acute Coronary Syndrome: A Literature Review

Akinrinmade¹,

Obitulata-Ugwu²,

Obijiofor³

et al. 2022

Cureus

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The coronavirus disease 2019, also known as the COVID-19 pandemic has had a deleterious impact on daily living, with health and socioeconomic effects of a global magnitude. Acute coronary syndrome (ACS), an important cardiovascular disease with significant morbidity and mortality rates, has been frequently reported in patients with this novel virus. This review aims to discuss the potential associations between COVID-19 and ACS with the use of multiple databases, including but not limited to; PubMed, ScienceDirect, World Health Organization, and American Heart Association.We have explored the pathophysiology of ACS, focusing on COVID-19 in particular with the use of various works of literature that highlights the pattern of viral entry and replication via the angiotensin-converting enzyme II. The review has also discussed the impact of the pandemic on hospital admissions, diagnosis, and management of ACS patients, as well as briefly highlighted a possible link between the widely available COVID-19 vaccines and possible cardiovascular complications.The association between COVID-19 and ACS needs more in-depth studies to help establish whether there exists a direct causal and or inciting correlation between them. Understanding this association might lead to new research and treatment options for ACS patients.

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“…A diffuse elevation of the ST segment and an upright divergence of the PR segment with ST-segment depression in lead aVR is common electrocardiogram (ECG) findings in patients with acute pericarditis [13]. Yildirim et al [14] reported different clinical pieces of evidence that the ECG signal of myocarditis was similar to that of Myocardial Infarction (MI). The reciprocal of the ST-segment elevation was observed in the ECG signal for acute myocarditis cases.…”

Section: Introductionmentioning

confidence: 99%

“…The reciprocal of the ST-segment elevation was observed in the ECG signal for acute myocarditis cases. It can have a variety of clinical symptoms and can be interpreted as myocardial infarction (MI) because patients typically have chest pain and electrocardiographic changes that are similar to those seen in acute ST-elevation MI [14]. Willemsen et al [15] analyzed three cases of chest pain.…”

Section: Introductionmentioning

confidence: 99%

Review of Computational Techniques for the Analysis of Abnormal Patterns of ECG Signal Provoked by Cardiac Disease

Jothiramalingam¹,

Anitha²,

Hemanth³

2021

Computer Modeling in Engineering &Amp; Sciences

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The 12-lead ECG aids in the diagnosis of myocardial infarction and is helpful in the prediction of cardiovascular disease complications. It does, though, have certain drawbacks. For other electrocardiographic anomalies such as Left Bundle Branch Block and Left Ventricular Hypertrophy syndrome, the ECG signal with Myocardial Infarction is difficult to interpret. These diseases cause variations in the ST portion of the ECG signal. It reduces the clarity of ECG signals, making it more difficult to diagnose these diseases. As a result, the specialist is misled into making an erroneous diagnosis by using the incorrect therapeutic technique. Based on these concepts, this article reviews the different procedures involved in ECG signal pre-processing, feature extraction, feature selection, and classification techniques to diagnose heart disorders such as Left Ventricular Hypertrophy, Bundle Branch Block, and Myocardial Infarction. It reveals the flaws and benefits in each segment, as well as recommendations for developing more advanced and robust methods for diagnosing these diseases, which will increase the system's accuracy. The current issues and prospective research directions are also addressed.

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Acute myocarditis mimicking myocardial infarction can misdirect the diagnostic approach

Cited by 4 publications

References 7 publications

Incidental Intramyocardial Bridging in a Myocarditis Patient Presenting With Focal ST Segment Depressions

Incidental Intramyocardial Bridging in a Myocarditis Patient Presenting With Focal ST Segment Depressions

COVID-19 and Acute Coronary Syndrome: A Literature Review

Review of Computational Techniques for the Analysis of Abnormal Patterns of ECG Signal Provoked by Cardiac Disease

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