Non-rheumatic streptococcal myocarditis mimicking acute myocardial infarction in an adolescent male

Abstract

An adolescent male with a recent history of streptococcal pharyngitis presented with severe substernal chest pain, troponin leak, and ST-segment elevation, which are suggestive of acute inferolateral myocardial infarction. The coronary angiogram was normal. The patient was subsequently diagnosed with non-rheumatic streptococcal myocarditis. He was treated with amoxicillin and had excellent recovery. Non-rheumatic streptococcal myocarditis is an important mimic of acute myocardial infarction in young adults.

A novel case of acute glomerulonephritis with concurrent acute non-rheumatic myocarditis following group a streptococcal infection

“…In severe cases, acute heart failure, systemic multiple organ dysfunction, and even sudden cardiac death can occur. 2,3,12,13 The pathogenesis of ANRSM remains unclear. Myocardial biopsy is mainly characterized by mononuclear cell infiltration, cardiomyocyte edema, and regional necrosis with the absence of streptococci, indicating the lack of direct myocardial infection.…”

“…In severe cases, acute heart failure, systemic multiple organ dysfunction, and even sudden cardiac death can occur. 2 , 3 , 12 , 13 …”

“…Although the mechanism of ANRSM remains unclear, most studies propose the involvement of streptococcal toxins. 2,3 We hereby report a novel case of concurrent acute PSGN and ANRSM after streptococcal infection.…”

From Streptococcal Pharyngitis/Tonsillitis to Myocarditis: A Systematic Review

“…The pathogenesis of nonrheumatic myocarditis following streptococcal pharyngitis or tonsillitis is still not clearly understood, and streptococcal toxins as well as cross-reactivity have been postulated as possible causative mechanisms [ 14 , 16 , 17 , 20 ]. However, the toxin theory seems to be more probable [ 22 ].…”