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2017 ; 96
(19
): e6863
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gab.com Text
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English Wikipedia
Clinical characteristics and outcomes of patients with myocarditis mimicking
ST-segment elevation myocardial infarction: Analysis of a case series
#MMPMID28489781
Wu S
; Yang YM
; Zhu J
; Wan HB
; Wang J
; Zhang H
; Shao XH
Medicine (Baltimore)
2017[May]; 96
(19
): e6863
PMID28489781
show ga
Acute myocarditis mimicking ST-segment elevation myocardial infarction (STEMI) is
highly deceptive for an accurate diagnosis, and a systematic study is lacking
with regard to the clinical features and prognosis of this distinct clinical
entity.Patients with suspected STEMI and eventually diagnosed with myocarditis by
cardiac magnetic resonance (CMR) from January 2012 to April 2016 at Fuwai
Hospital were identified by reviewing medical records and electronic databases.
Follow-up was conducted by clinical visits and phone contacts in a median
duration of 17 months.A total of 18 patients were included in the study, with 17
males and 1 female. They were relatively young, and their mean age was 30.8
years. 94.4% of the patients had a high prevalence of infectious prodrome, and
inflammatory biomarkers were notably elevated in all patients. Late gadolinium
enhancement on CMR was detected in 13 patients. Three patients underwent
fulminant course, and left ventricular ejection fraction (LVEF) <45% on admission
occurred in 3 patients. The median LVEF improved from 59% on admission to 65% at
discharge (P?<.001), and none developed cardiac insufficiency, heart
transplantation, or death during a median follow-up of 17 months.Myocarditis
mimicking STEMI is featured by young age and an existence of flu-like prodrome.
CMR benefits the differential diagnosis of this unique clinical entity. Notably,
patients with myocarditis mimicking STEMI had a favorable prognosis, and
establishing an accurate diagnosis is crucial to avoid unreasonable treatments
for them.