Acute myocarditis mimicking ST-elevation myocardial infarction has been reported in
the literature, and most of the cases had relatively normal coronary arteries. However,
there is no literature mentioning fulminant myocarditis complicated with obstructive
myocardial infarction. Herein, we report a 72-year-old male suffering from progressive
dyspnea and acute chest pain after recent common cold episode. Electrocardiography
revealed ST elevation over inferior leads and emergent coronary angiography showed
right coronary artery occlusion, but left ventriculography revealed poor left ventricular
(LV) function with global hypokinesia, different from previously normal echocardiographic
finding 3 months previously. After percutaneous coronary intervention, extracorporeal
membrane oxygenation was also instituted due to unstable hemodynamic and electrical
conduction disturbance. Fulminant myocarditis was highly suspected according to the
clinical course and incompatible LV function. This patient finally expired a few days
later due to no obvious recovery of LV function and family's willing. This case reminds
physicians that acute coronary occlusion is still a possible but extremely rare complication
of fulminant myocarditis. Despite intensive mechanical support, this kind of patient
might have poorer prognosis than other myocarditis cases without coronary occlusion
and hence need more attention.
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Article Info
Publication History
Published online: February 04, 2013
Accepted:
October 2,
2012
Received:
September 26,
2012
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.