A CLINICAL CASE OF ACUTE ALLERGIC MYOCARDITIS SIMULATING MYOCARDIAL INFARCTION
Objective: to describe a clinical case of evolving acute eosinophilic myocarditis simulating coronary heart disease. Subjects and methods. Patient B. aged 62 years was admitted to Intensive Care Unit Fifteen, N.I. Pirogov First Moscow City Clinical Hospital, by being transferred from Thailand with a...
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| Format: | Article |
| Language: | Russian |
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ABV-press
2015-05-01
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| Series: | Klinicist |
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| Online Access: | https://klinitsist.abvpress.ru/Klin/article/view/183 |
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| author | N. A. Shostak A. A. Klimenko V. S. Shemenkova N. V. Zaikina |
| author_facet | N. A. Shostak A. A. Klimenko V. S. Shemenkova N. V. Zaikina |
| author_sort | N. A. Shostak |
| collection | DOAJ |
| description | Objective: to describe a clinical case of evolving acute eosinophilic myocarditis simulating coronary heart disease. Subjects and methods. Patient B. aged 62 years was admitted to Intensive Care Unit Fifteen, N.I. Pirogov First Moscow City Clinical Hospital, by being transferred from Thailand with a referral diagnosis of acute myocardial infarction made on November 1, 2012, with complaints of pressing and aching heart pains. At a Phuket hospital, his electrocardiogram recorded atrial fibrillation; indirect cardiac massage, electric pulse therapy, and mechanical ventilation were performed. After being admitted to the N.I. Pirogov First Moscow City Clinical Hospital, the patient underwent examination: estimation of laboratory indicators over time, electrocardiography (ECG), echocardiography, Holter ECG monitoring, and myocardial scintigraphy. Results. The patient had a history of an allergic reaction as urticaria to the ingestion of fish products. His examination showed practically all diagnostic criteria for allergic myocarditis: hypereosinophilia (the admission level of eosinophils was 9% with their further normalization); the characteristic clinical presentation of myocarditis (pressing retrosternal pain); elevated levels of cardiac specific enzymes (creatinine phosphokinase-MB, lactate dehydrogenase, troponin T); ECG changes – myocardial hypokinesis in the acute period, followed by its pattern normalization. of the pattern. Myocardial scintigraphy (by taking into account the fact that the patient had had a new allergic reaction episode, the investigators decided not to perform coronary angiography) revealed decreased radiopharmaceutical accumulation in the lower left ventricular wall in the right coronary arterial bed; perfusion remained in the other myocardial walls. Conclusion. This clinical case reflects the specific features of the course of and difficulties in the diagnosis of acute allergic myocarditis that, in most cases, has no specific clinical manifestations and may mimic different diseases. |
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| issn | 1818-8338 |
| language | Russian |
| last_indexed | 2025-02-18T01:39:35Z |
| publishDate | 2015-05-01 |
| publisher | ABV-press |
| record_format | Article |
| series | Klinicist |
| spelling | doaj.art-8578ac5382a74d13bdd08dd07d7c26482024-11-26T12:06:15ZrusABV-pressKlinicist1818-83382015-05-0191565910.17650/1818-8338-2015-1-56-59188A CLINICAL CASE OF ACUTE ALLERGIC MYOCARDITIS SIMULATING MYOCARDIAL INFARCTIONN. A. Shostak0A. A. Klimenko1V. S. Shemenkova2N. V. Zaikina3Acad. A.I. Nesterov Department of Faculty Therapy, N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia; 1 Ostrovityanovа St., Moscow 117997, Russia;Acad. A.I. Nesterov Department of Faculty Therapy, N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia; 1 Ostrovityanovа St., Moscow 117997, Russia;Acad. A.I. Nesterov Department of Faculty Therapy, N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia; 1 Ostrovityanovа St., Moscow 117997, Russia;N.I. Pirogov First City Clinical Hospital, Moscow Health Department; 8 Leninsky Prospect, Moscow, 117049, RussiaObjective: to describe a clinical case of evolving acute eosinophilic myocarditis simulating coronary heart disease. Subjects and methods. Patient B. aged 62 years was admitted to Intensive Care Unit Fifteen, N.I. Pirogov First Moscow City Clinical Hospital, by being transferred from Thailand with a referral diagnosis of acute myocardial infarction made on November 1, 2012, with complaints of pressing and aching heart pains. At a Phuket hospital, his electrocardiogram recorded atrial fibrillation; indirect cardiac massage, electric pulse therapy, and mechanical ventilation were performed. After being admitted to the N.I. Pirogov First Moscow City Clinical Hospital, the patient underwent examination: estimation of laboratory indicators over time, electrocardiography (ECG), echocardiography, Holter ECG monitoring, and myocardial scintigraphy. Results. The patient had a history of an allergic reaction as urticaria to the ingestion of fish products. His examination showed practically all diagnostic criteria for allergic myocarditis: hypereosinophilia (the admission level of eosinophils was 9% with their further normalization); the characteristic clinical presentation of myocarditis (pressing retrosternal pain); elevated levels of cardiac specific enzymes (creatinine phosphokinase-MB, lactate dehydrogenase, troponin T); ECG changes – myocardial hypokinesis in the acute period, followed by its pattern normalization. of the pattern. Myocardial scintigraphy (by taking into account the fact that the patient had had a new allergic reaction episode, the investigators decided not to perform coronary angiography) revealed decreased radiopharmaceutical accumulation in the lower left ventricular wall in the right coronary arterial bed; perfusion remained in the other myocardial walls. Conclusion. This clinical case reflects the specific features of the course of and difficulties in the diagnosis of acute allergic myocarditis that, in most cases, has no specific clinical manifestations and may mimic different diseases.https://klinitsist.abvpress.ru/Klin/article/view/183myocarditisacute allergic myocarditisdifferential diagnosis of myocarditismyocarditis and myocardial infarctioneosinophilic myocarditissudden cardiac deathmyocardial inflammatory diseaseschest painclinical presentation of myocarditisacut |
| spellingShingle | N. A. Shostak A. A. Klimenko V. S. Shemenkova N. V. Zaikina A CLINICAL CASE OF ACUTE ALLERGIC MYOCARDITIS SIMULATING MYOCARDIAL INFARCTION Klinicist myocarditis acute allergic myocarditis differential diagnosis of myocarditis myocarditis and myocardial infarction eosinophilic myocarditis sudden cardiac death myocardial inflammatory diseases chest pain clinical presentation of myocarditis acut |
| title | A CLINICAL CASE OF ACUTE ALLERGIC MYOCARDITIS SIMULATING MYOCARDIAL INFARCTION |
| title_full | A CLINICAL CASE OF ACUTE ALLERGIC MYOCARDITIS SIMULATING MYOCARDIAL INFARCTION |
| title_fullStr | A CLINICAL CASE OF ACUTE ALLERGIC MYOCARDITIS SIMULATING MYOCARDIAL INFARCTION |
| title_full_unstemmed | A CLINICAL CASE OF ACUTE ALLERGIC MYOCARDITIS SIMULATING MYOCARDIAL INFARCTION |
| title_short | A CLINICAL CASE OF ACUTE ALLERGIC MYOCARDITIS SIMULATING MYOCARDIAL INFARCTION |
| title_sort | clinical case of acute allergic myocarditis simulating myocardial infarction |
| topic | myocarditis acute allergic myocarditis differential diagnosis of myocarditis myocarditis and myocardial infarction eosinophilic myocarditis sudden cardiac death myocardial inflammatory diseases chest pain clinical presentation of myocarditis acut |
| url | https://klinitsist.abvpress.ru/Klin/article/view/183 |
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