Abstract
The present study describes the case of a 39-year-old man who had acute retrosternal pain, history of upper tract infection and low-grade fever 3 days prior to presentation, elevated cardiac markers and electrocardiographic ST-T changes, which led to an original suspicion of acute myocarditis. The patient underwent coronary angiography after 36 hours to rule out coronary artery disease, which revealed normal coronary arteries.
Highlights
Myocarditis is inflammation of the myocardium, the cardiac muscle
The present study describes the case of a 39-year-old man who had acute retrosternal pain, history of upper tract infection and low-grade fever 3 days prior to presentation, elevated cardiac markers and electrocardiographic ST-T changes, which led to an original suspicion of acute myocarditis
The diagnosis of viral myocarditis was confirmed on consideration of his normal coronary angiography, fever, history of upper tract infection and other auxiliary examination results obtained in the following days, which were supportive of the diagnosis
Summary
Myocarditis is inflammation of the myocardium, the cardiac muscle. Acute myocarditis is most commonly caused by viral infections; it may less commonly be caused by non-infectious etiologies. We report here the initial presentation, medical care, and clinical course of a patient presenting with acute myocarditis. On April 24, 2018, physical examination showed that his blood pressure was 130/80 mmHg, temperature was 37.7 °C and heart rate was 79 bpm. A chest X-ray showed a normal heart size and mild markings in the lungs, with no clear indication of substantive lesion. An echocardiogram showed that the patient’s heart functioned normally with an ejection fraction of Citation: Patrick L (2021) High Level of Suspicion Based on Detailed Medical History and Focused Physical Examination: Important Tool to Diagnose Acute Myocarditis. A standard 12-lead ECG on the third day showed that the diffuse elevated ST segment began to fall back. A holter ECG (24 hours) after 2 months showed normal sinus rhythm without arrhythmias
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