title: An unusual case of fulminant myocarditis closely mimicking ST-segment elevation myocardial infarction and presenting as refractory cardiogenic shock complicated by multiple life-threatening arrhythmias.
abstract: We report a case of severe fulminant myocarditis that closely mimicked acute inferior ST-segment elevation myocardial infarction (STEMI) and presented with refractory cardiogenic shock, multiple life-threatening arrhythmias and rapidly progressive liver failure. This case was successfully differentiated from STEMI by emergency coronary angiography. Recurrent cardiogenic shock was reversed by intra-aortic balloon pumping (IABP). Life-threatening arrhythmias including ventricular tachycardia, ventricular fibrillation, and high-degree atrioventricular block (AVB) were terminated by immediate cardioversion and temporary pacemaker. High-dose hydrocortisone effectively attenuated the inflammatory injury to the myocardium. The patient recovered and was well at the follow-up visit four months after discharge.
authors.affiliation: Department of Cardiology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China. Electronic address: wangzq007@hotmail.com.
authors.forename: Zhi-quan
authors.initials: ZQ
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Yi-Gang
authors.initials: YG
authors.lastname: Li
mesh_terms: D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D009203:Myocardial Infarction; D009205:Myocarditis / Q000175:diagnosis*; D000072657:ST Elevation Myocardial Infarction / Q000175:diagnosis*; D012770:Shock, Cardiogenic
keywords: Balão intra-aórtico; Cardiac pacemaker; Cardiogenic shock; Choque cardiogénico; Fulminant myocarditis; Intra-aortic balloon pump; Miocardite fulminante; Pacemaker cardíaco