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Open Access Highly Accessed Case report

Acute perimyocarditis mimicking transmural myocardial infarction

Hesham R Omar1*, Ahmed Fathy2, Rania Rashad3 and Mohamed Elghonemy3

Author Affiliations

1 Department of Cardiology, Cairo University Hospital, Cairo, Egypt

2 Department of Cardiology, National Heart Institute, Cairo Egypt

3 Department of Critical Care Medicine, Cairo University Hospital, Cairo, Egypt

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International Archives of Medicine 2009, 2:37  doi:10.1186/1755-7682-2-37

Published: 9 December 2009


Although acute pericarditis has charachteristic electrocardiographic (ECG) findings that differentiate it from acute ST segment elevation myocardial infarction (MI); in certain cases diagnosis is somewhat difficult especially when the ECG reveals focal instead of diffuse changes and moreover when pericarditis is associated with an underlying myocarditis causing elevation of the cardiac biomarkers therefore increasing the difficulty in differentiating between both enteties. This is especially important because adverse lethal side effect can occur if thrombolytic therapy is administered for a patient with acute pericarditis, or if a diagnosis of transmural MI is missed. In this case report we are describing an 18 year old male patient who presented with an acute onset of severe chest pain associated with focal ECG changes and elevated cardiac enzymes mimicking transmural MI. This report aims to sensitize readers to this debate and create awareness among cardiologists and intensivists with both presentations and how to reach an accurate diagnosis.