Acute perimyocarditis mimicking acute myocardial infarction in a 12-year-old boy with Duchenne muscular dystrophy
Differential diagnosis of chest pain in the pediatric population is important but can be challenging. A 12-year-old boy with Duchenne muscular dystrophy presented with chest pain, cardiac enzyme elevation, and convex ST elevations in the inferior leads with reciprocal ST depression in the anterior l...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Korean Society of Critical Care Medicine
2022-05-01
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| Series: | Acute and Critical Care |
| Subjects: | |
| Online Access: | http://www.accjournal.org/upload/pdf/acc-2021-00290.pdf |
| _version_ | 1818002147099279360 |
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| author | Ho Jung Choi Hye Won Kwon Kyung Jin Oh Mi Kyoung Song |
| author_facet | Ho Jung Choi Hye Won Kwon Kyung Jin Oh Mi Kyoung Song |
| author_sort | Ho Jung Choi |
| collection | DOAJ |
| description | Differential diagnosis of chest pain in the pediatric population is important but can be challenging. A 12-year-old boy with Duchenne muscular dystrophy presented with chest pain, cardiac enzyme elevation, and convex ST elevations in the inferior leads with reciprocal ST depression in the anterior leads on electrocardiogram. Echocardiography on admission revealed normal left ventricular function. Suspecting acute myocardial infarction, we performed invasive coronary angiography, which revealed normal coronary arteries. A follow-up electrocardiogram showed an acute pericarditis pattern with concave ST elevations in most leads and PR depression, and follow-up echocardiography revealed global left ventricular dysfunction, suggestive of acute perimyocarditis. Ibuprofen was administered for acute pericarditis, and a continuous milrinone infusion was commenced for myocardial dysfunction. The chest pain improved by the next day, and the ST segment elevations normalized on day 4. Echocardiography on day 9 revealed improved left ventricular function. The patient was discharged on day 11, and he is doing well without chest pain through 12 months of follow-up. The last electrocardiogram showed normal sinus rhythm without ST change. Differential diagnosis of acute myocardial infarction and acute perimyocarditis is important for proper treatment strategies and the different prognoses of these two conditions. |
| first_indexed | 2024-04-14T03:42:56Z |
| format | Article |
| id | doaj.art-121fd4c201174fdf91d47c6652db0821 |
| institution | Directory Open Access Journal |
| issn | 2586-6052 2586-6060 |
| language | English |
| last_indexed | 2024-04-14T03:42:56Z |
| publishDate | 2022-05-01 |
| publisher | Korean Society of Critical Care Medicine |
| record_format | Article |
| series | Acute and Critical Care |
| spelling | doaj.art-121fd4c201174fdf91d47c6652db08212022-12-22T02:14:25ZengKorean Society of Critical Care MedicineAcute and Critical Care2586-60522586-60602022-05-0137225826210.4266/acc.2021.002901321Acute perimyocarditis mimicking acute myocardial infarction in a 12-year-old boy with Duchenne muscular dystrophyHo Jung Choi0Hye Won Kwon1Kyung Jin Oh2Mi Kyoung Song3 Department of Pediatrics, Seoul National University Hospital, Seoul, Korea Department of Pediatrics, Seoul National University Hospital, Seoul, Korea Department of Pediatrics, Seoul National University Hospital, Seoul, Korea Department of Pediatrics, Seoul National University Hospital, Seoul, KoreaDifferential diagnosis of chest pain in the pediatric population is important but can be challenging. A 12-year-old boy with Duchenne muscular dystrophy presented with chest pain, cardiac enzyme elevation, and convex ST elevations in the inferior leads with reciprocal ST depression in the anterior leads on electrocardiogram. Echocardiography on admission revealed normal left ventricular function. Suspecting acute myocardial infarction, we performed invasive coronary angiography, which revealed normal coronary arteries. A follow-up electrocardiogram showed an acute pericarditis pattern with concave ST elevations in most leads and PR depression, and follow-up echocardiography revealed global left ventricular dysfunction, suggestive of acute perimyocarditis. Ibuprofen was administered for acute pericarditis, and a continuous milrinone infusion was commenced for myocardial dysfunction. The chest pain improved by the next day, and the ST segment elevations normalized on day 4. Echocardiography on day 9 revealed improved left ventricular function. The patient was discharged on day 11, and he is doing well without chest pain through 12 months of follow-up. The last electrocardiogram showed normal sinus rhythm without ST change. Differential diagnosis of acute myocardial infarction and acute perimyocarditis is important for proper treatment strategies and the different prognoses of these two conditions.http://www.accjournal.org/upload/pdf/acc-2021-00290.pdfcase reportmyocarditispericarditisst elevation myocardial infarction |
| spellingShingle | Ho Jung Choi Hye Won Kwon Kyung Jin Oh Mi Kyoung Song Acute perimyocarditis mimicking acute myocardial infarction in a 12-year-old boy with Duchenne muscular dystrophy Acute and Critical Care case report myocarditis pericarditis st elevation myocardial infarction |
| title | Acute perimyocarditis mimicking acute myocardial infarction in a 12-year-old boy with Duchenne muscular dystrophy |
| title_full | Acute perimyocarditis mimicking acute myocardial infarction in a 12-year-old boy with Duchenne muscular dystrophy |
| title_fullStr | Acute perimyocarditis mimicking acute myocardial infarction in a 12-year-old boy with Duchenne muscular dystrophy |
| title_full_unstemmed | Acute perimyocarditis mimicking acute myocardial infarction in a 12-year-old boy with Duchenne muscular dystrophy |
| title_short | Acute perimyocarditis mimicking acute myocardial infarction in a 12-year-old boy with Duchenne muscular dystrophy |
| title_sort | acute perimyocarditis mimicking acute myocardial infarction in a 12 year old boy with duchenne muscular dystrophy |
| topic | case report myocarditis pericarditis st elevation myocardial infarction |
| url | http://www.accjournal.org/upload/pdf/acc-2021-00290.pdf |
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