The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지

A Case of Acute Myopericarditis with Localized ST Elevation Mimicking Myocardial Infarction

국한된 ST 분절 상승을 보인 심근경색으로 오인된 급성 심근심막염 1예

  • Kim, Tae-Wook (Department of Internal Medicine, Wallace Memorial Baptist Hospital) ;
  • Jeong, Min-Jeong (Department of Internal Medicine, Wallace Memorial Baptist Hospital) ;
  • Im, Jun-Young (Department of Internal Medicine, Wallace Memorial Baptist Hospital) ;
  • Jeong, Jae-Shik (Department of Internal Medicine, Wallace Memorial Baptist Hospital) ;
  • Park, Mi-Ran (Department of Internal Medicine, Wallace Memorial Baptist Hospital) ;
  • Park, Ju-Cheol (Department of Internal Medicine, Wallace Memorial Baptist Hospital) ;
  • Jeong, Joon-Hoon (Department of Internal Medicine, Wallace Memorial Baptist Hospital)
  • 김태욱 (왈레스 기념 침례병원 내과) ;
  • 정민정 (왈레스 기념 침례병원 내과) ;
  • 임준영 (왈레스 기념 침례병원 내과) ;
  • 정재식 (왈레스 기념 침례병원 내과) ;
  • 박미란 (왈레스 기념 침례병원 내과) ;
  • 박주철 (왈레스 기념 침례병원 내과) ;
  • 정준훈 (왈레스 기념 침례병원 내과)
  • Published : 2011.01.01
⟨ Previous Next ⟩

Abstract

Although, with regard to diagnosis, history, physical examination, laboratory data, and electrocardiogram (ECG) are helpful, it can be difficult to distinguish between pericarditis, myopericarditis, and myocardial infarction. Typically, the ECG pattern evolves similarly in acute pericarditis and myopericarditis and includes diffuse ST elevation and PR depression, and then diffuse T wave inversion. Nevertheless, atypical ECG features are seen occasionally in both, especially in myopericarditis. They are characterized by localized ST elevation (inferolateral or anterolateral) and T wave inversion before ST segment normalization. This makes it difficult to distinguish acute myopericarditis from acute myocardial infarction. We report the case of a 27-year-old man with acute myopericarditis with localized ST elevation mimicking acute myocardial infarction.

본 증례의 환자는 급성 상기도 감염의 증상 이후 발생한 흉부 불편감을 주소로 내원하였고, 국한된 ST 분절의 상승과 심근 효소의 상승으로 급성 심근경색증이 의심되었으나, 심장초음파 및 관상동맥 조영술을 시행한 이후 급성 심근심막염으로 진단할 수 있었고, 이를 대증적 치료로 완치하였다. 이에 본 저자들은 급성 심근경색증의 소견을 보인 급성 심근심막염 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

References

  1. Zayas R, Anguita M, Torres F, Gimenez D, Bergillos F, Ruiz M, Ciudad M, Gallardo A, Valles F. Incidence of specific etiology and role of methods for specific etiologic diagnosis of primary acute pericarditis. Am J Cardiol 1995;75:378-382. https://doi.org/10.1016/S0002-9149(99)80558-X
  2. Spodick DH. Acute pericarditis: current concepts and practice. JAMA 2003;289:1150-1153. https://doi.org/10.1001/jama.289.9.1150
  3. Imazio M, Demichelis B, Cecchi E, Belli R, Ghisio A, Bobbio M, Trinchero R. Cardiac troponin I in acute pericarditis. J Am Coll Cardiol 2003;42:2144-2148. https://doi.org/10.1016/j.jacc.2003.02.001
  4. Imazio M, Trinchero R. Myopericarditis: etiology, management, and prognosis. Int J Cardiol 2008;127:17-26. https://doi.org/10.1016/j.ijcard.2007.10.053
  5. Imazio M, Trinchero R. Myopericarditis: etiology, management, and prognosis. Int J Cardiol 2008;127:17-26. https://doi.org/10.1016/j.ijcard.2007.10.053
  6. Imazio M, Cecchi E, Demichelis B, Chinaglia A, Ierna S, Demarie D, Ghisio A, Pomari F, Belli R, Trinchero R. Myopericarditis versus viral or idiopathic acute pericarditis. Heart 2008;94:498-501.
  7. Troughton RW, Asher CR, Klein AL. Pericarditis. Lancet 2004; 363:717-727. https://doi.org/10.1016/S0140-6736(04)15648-1
  8. Lange RA, Hillis LD. Clinical practice: acute pericarditis. N Engl J Med 2004;351:2195-2202. https://doi.org/10.1056/NEJMcp041997
  9. Imazio M, Demichelis B, Parrini I, Giuggia M, Cecchi E, Gaschino G, Demarie D, Ghisio A, Trinchero R. Day-hospital treatment of acute pericarditis: a management program for outpatient therapy. J Am Coll Cardiol 2004;43:1042-1046. https://doi.org/10.1016/j.jacc.2003.09.055
  10. Brandt RR, Filzmaier K, Hanrath P. Circulating cardiac troponin I in acute pericarditis. Am J Cardiol 2001;87:1326-1328. https://doi.org/10.1016/S0002-9149(01)01536-3
  11. Khavandi A, Whitaker J, Elkington A, Probert J, Walker PR. Acute streptococcal myopericarditis mimicking myocardial infarction. Am J Emerg Med 2008;26:638.e1-2. https://doi.org/10.1016/S0735-6757(08)00673-6
  12. Nisbet BC, Breyer M. Acute myopericarditis with focal ECG findings mimicking acute myocardial infarction. J Emerg Med 2010; 39:E153-E158. https://doi.org/10.1016/j.jemermed.2008.01.013
  13. Choi IK, Oh SB, Kang KH, Lee YJ, Kim IP, Koh HS. Tako-tsubo Syndrome after acute traumatic subdural hematoma mimicking acute ST elevation myocardial infarction. J Korean Soc Emerg Med 2008;19:777-782.
  14. Seo YB, Yang DH, Cheong ER, Kwack DH, Heo JH, Park MK, Park HS, Jo YG, Chae SC, Jun JE, Park WH. A case of traumatic acute pericarditis mimicking acute myocardial infarction, caused by swallowing fishhook. Korean Circ J 2003;33:821-826 https://doi.org/10.4070/kcj.2003.33.9.821