title: Electrocardiographic changes in acute perimyocarditis.
abstract: Pericarditis and myocarditis are characterised by electrocardiographic changes and elevated cardiac enzymes, respectively, and patients with perimyocarditis often complain of chest discomfort. These findings are nonspecific and often lead to diagnostic difficulties, as ST-elevation myocardial infarction commonly presents in a similar fashion. Clinical differentiation between perimyocarditis and myocardial infarction are especially important because adverse side effects can occur if reperfusion therapy is administered for a patient with acute pericarditis or if a diagnosis of acute myocardial infarction is missed. We herein describe a case of perimyocarditis with ST elevation and raised cardiac markers, which led to two emergency coronary angiographies that were subsequently found to be normal. We include the three serial electrocardiographies (ECGs) performed to show the characteristic features of perimyocarditis and further discuss the importance of identifying typical and atypical ECG features of pericarditis.
authors: Department of Cardiology, National Heart Centre Singapore, 17 Third Hospital Avenue, Singapore 168752. phongteck.lee@mohh.com.sg.
authors: Phong Teck
authors: PT
authors: Lee
authors: Chai Keat
authors: CK
authors: See
authors: Paul Toon Lim
authors: PT
authors: Chiam
authors: Soo Teik
authors: ST
authors: Lim
mesh_terms: D000208:Acute Disease; D000368:Aged; D001706:Biopsy; D001794:Blood Pressure; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D009203:Myocardial Infarction / Q000473:pathology; D009205:Myocarditis / Q000175:diagnosis* / Q000503:physiopathology*
references: J Am Coll Cardiol. 2004 Mar 17;43(6):1042-6
references: 15028364