Symptomatic Young Adults with ST-Segment Elevation—Acute Coronary Syndrome or Myocarditis: The Three-Factor Diagnostic Model
Myocarditis may mimic myocardial infarction (MI) due to a similar clinical presentation, including chest pain, electrocardiography changes, and laboratory findings. The purpose of the study was to investigate the diagnostic value of clinical, laboratory, and electrocardiography characteristics of pa...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-02-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/4/916 |
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| author | Paulina Wieczorkiewicz Katarzyna Przybylak Karolina Supel Michal Kidawa Marzenna Zielinska |
| author_facet | Paulina Wieczorkiewicz Katarzyna Przybylak Karolina Supel Michal Kidawa Marzenna Zielinska |
| author_sort | Paulina Wieczorkiewicz |
| collection | DOAJ |
| description | Myocarditis may mimic myocardial infarction (MI) due to a similar clinical presentation, including chest pain, electrocardiography changes, and laboratory findings. The purpose of the study was to investigate the diagnostic value of clinical, laboratory, and electrocardiography characteristics of patients with acute coronary syndrome - like myocarditis and MI. We analysed 90 patients (≤45 years old) with an initial diagnosis of ST-segment elevation myocardial infarction; 40 patients (44.4%), through the use of cardiac magnetic resonance, were confirmed to have myocarditis, and 50 patients (55.6%) were diagnosed with MI. Patients with myocarditis were younger and had fewer cardiovascular risk factors than those with MI. The cutoff value distinguishing between myocarditis and MI was defined as the age of 36 years. The history of recent infections (82.5% vs. 6%) and C-reactive protein (CRP) levels on admission (Me 45.9 vs. 3.4) was more associated with myocarditis. Further, the QTc interval was inversely correlated with the echocardiographic ejection fraction in both groups but was significantly longer in patients with MI. Non-invasive diagnostics based on clinical features and laboratory findings are basic but still essential tools for differentiation between MI and myocarditis. The three-factor model including the criteria of age, abnormal CRP, and history of recent infections might become a valuable clinical indication. |
| first_indexed | 2024-03-09T21:42:12Z |
| format | Article |
| id | doaj.art-742d9603922c45a0afd2f47465d744ce |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T21:42:12Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-742d9603922c45a0afd2f47465d744ce2023-11-23T20:28:53ZengMDPI AGJournal of Clinical Medicine2077-03832022-02-0111491610.3390/jcm11040916Symptomatic Young Adults with ST-Segment Elevation—Acute Coronary Syndrome or Myocarditis: The Three-Factor Diagnostic ModelPaulina Wieczorkiewicz0Katarzyna Przybylak1Karolina Supel2Michal Kidawa3Marzenna Zielinska4Department of Interventional Cardiology, Medical University of Lodz, 92-213 Lodz, PolandDepartment of Interventional Cardiology, Medical University of Lodz, 92-213 Lodz, PolandDepartment of Interventional Cardiology, Medical University of Lodz, 92-213 Lodz, PolandDepartment of Interventional Cardiology, Medical University of Lodz, 92-213 Lodz, PolandDepartment of Interventional Cardiology, Medical University of Lodz, 92-213 Lodz, PolandMyocarditis may mimic myocardial infarction (MI) due to a similar clinical presentation, including chest pain, electrocardiography changes, and laboratory findings. The purpose of the study was to investigate the diagnostic value of clinical, laboratory, and electrocardiography characteristics of patients with acute coronary syndrome - like myocarditis and MI. We analysed 90 patients (≤45 years old) with an initial diagnosis of ST-segment elevation myocardial infarction; 40 patients (44.4%), through the use of cardiac magnetic resonance, were confirmed to have myocarditis, and 50 patients (55.6%) were diagnosed with MI. Patients with myocarditis were younger and had fewer cardiovascular risk factors than those with MI. The cutoff value distinguishing between myocarditis and MI was defined as the age of 36 years. The history of recent infections (82.5% vs. 6%) and C-reactive protein (CRP) levels on admission (Me 45.9 vs. 3.4) was more associated with myocarditis. Further, the QTc interval was inversely correlated with the echocardiographic ejection fraction in both groups but was significantly longer in patients with MI. Non-invasive diagnostics based on clinical features and laboratory findings are basic but still essential tools for differentiation between MI and myocarditis. The three-factor model including the criteria of age, abnormal CRP, and history of recent infections might become a valuable clinical indication.https://www.mdpi.com/2077-0383/11/4/916myocarditisST-elevation myocardial infarctionyoung adults |
| spellingShingle | Paulina Wieczorkiewicz Katarzyna Przybylak Karolina Supel Michal Kidawa Marzenna Zielinska Symptomatic Young Adults with ST-Segment Elevation—Acute Coronary Syndrome or Myocarditis: The Three-Factor Diagnostic Model Journal of Clinical Medicine myocarditis ST-elevation myocardial infarction young adults |
| title | Symptomatic Young Adults with ST-Segment Elevation—Acute Coronary Syndrome or Myocarditis: The Three-Factor Diagnostic Model |
| title_full | Symptomatic Young Adults with ST-Segment Elevation—Acute Coronary Syndrome or Myocarditis: The Three-Factor Diagnostic Model |
| title_fullStr | Symptomatic Young Adults with ST-Segment Elevation—Acute Coronary Syndrome or Myocarditis: The Three-Factor Diagnostic Model |
| title_full_unstemmed | Symptomatic Young Adults with ST-Segment Elevation—Acute Coronary Syndrome or Myocarditis: The Three-Factor Diagnostic Model |
| title_short | Symptomatic Young Adults with ST-Segment Elevation—Acute Coronary Syndrome or Myocarditis: The Three-Factor Diagnostic Model |
| title_sort | symptomatic young adults with st segment elevation acute coronary syndrome or myocarditis the three factor diagnostic model |
| topic | myocarditis ST-elevation myocardial infarction young adults |
| url | https://www.mdpi.com/2077-0383/11/4/916 |
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