Presumptive myocarditis with ST-Elevation myocardial infarction presentation in young males as a new syndrome. Clinical significance and long term follow up.
BACKGROUND
Acute myocarditis may mimic myocardial infarction, since affected patients complain of "typical" chest pain, the ECG changes are identical to those observed in acute coronary syndromes, and serum markers are increased. We describe a case series of presumptive myocarditis with ST segment elevation on admission ECG.


RESULTS
From 1998 to 2009, 21 patients (20 males; age 17-42 years) were admitted with chest pain, persistent ST segment elevation, serum enzyme and troponine release. All but one patients had fever and flu-like symptoms prior to admission. No abnormal Q wave appeared in any ECG tracing, and angiography did not show significant coronary artery disease. Patients remained asymptomatic at long term follow-up, except 2 who experienced a late relapse, with the same clinical, electrocardiographic and serum findings as in the first clinical presentation.


CONCLUSIONS
Presumptive myocarditis of possible viral origin characterized by ST elevation mimicking myocardial infarction, good short term prognosis and some risk for recurrence is relatively frequent in young males and appears as a distinct clinical condition.
Struttura Complessa di Cardiologia, Ospedale Santa Caterina Novella, Galatina, Italy.
Marcello
M
Costantini
Giuseppe
G
Oreto
Alberto
A
Albanese
Anna
A
Ranieri
Giovanni
G
De Fabrizio
Iovanni
I
Sticchi
Antonio
A
Lauretti
Sergio
S
Capone
Cristina
C
Tritto
Claudio
C
Fachechi
Realino
R
Renna
Antonio
A
Montinaro
Eugenio
E
Picano
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D002637:Chest Pain / Q000000981:diagnostic imaging; D017023:Coronary Angiography; D003937:Diagnosis, Differential; D004452:Echocardiography / Q000379:methods*; D004562:Electrocardiography; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000000981:diagnostic imaging*; D009205:Myocarditis / Q000000981:diagnostic imaging*; D013577:Syndrome
D015415:Biomarkers
J Virol. 1999 Jun;73(6):4689-95
10233928
Brain Res. 2006 Dec 18;1126(1):139-47
16949558
J Clin Invest. 2006 May;116(5):1254-63
16604192
Ann Intern Med. 2004 Dec 7;141(11):858-65
15583228
Int J Cardiol. 2005 May 11;101(1):157-8
15860403
Am J Pathol. 1987 Mar;126(3):432-8
3030117
Eur Heart J. 2007 Jun;28(11):1326-33
17493945
Cell Immunol. 1987 Apr 1;105(2):332-9
3494528
N Engl J Med. 1993 Jan 14;328(2):100-4
8416421
Circulation. 2006 Feb 14;113(6):876-90
16476862
Postgrad Med J. 2007 Apr;83(978):261-4
17403953
J Am Coll Cardiol. 2001 Mar 1;37(3):786-92
11693753
Circulation. 2007 Nov 6;116(19):2216-33
17959655
Med Microbiol Immunol. 2005 May;194(3):121-7
15107990