RESUMO
Myopericarditis is commonly misdiagnosed as an acute coronary syndrome (ACS) due to the similarities in clinical presentation. Hence, accurate diagnosis is important to ensure appropriate care and improve outcomes. Here, we present the case of a 58-year-old male initially diagnosed with ACS, which was eventually identified to be a case of myopericarditis and managed accordingly. The patient presented with fever for 1 week during the coronavirus disease pandemic and developed signs of ACS subsequently. Clinical history, biomarker profile, and echocardiogram suggested ACS. However, cardiac magnetic resonance imaging and coronary angiography findings revealed myopericarditis and it was managed accordingly. Clinicians should be aware of myopericarditis masquerading as ACS in the post-viral period.
RESUMO
The safety of thrombolytic therapy for acute myocardial infarction in the elderly population has not been clearly established. In a retrospective study we evaluated the efficacy and complications of thrombolytic therapy in the elderly as compared to younger patients. Consecutive 588 patients who received thrombolytic therapy were studied. Clinical data in 136 patients aged above 65 years were compared with 85 patients below 40 years. Cigarette smoking was a common risk factor in the young (46 vs 13; p < 0.0001). Coexistent systemic diseases and conduction system disturbances (28 vs 9; p < 0.05) were common in the older patients, but the incidence of bleeding complications to thrombolytic therapy (6 vs 1; p = NS) was not found to be higher. Ninety percent of the elderly who had cardiogenic shock died. There was no significant difference between the two groups in reinfarction rate (12 vs 15; p = NS) and post-infarct angina (20 vs 20; p = NS). Coronary angiography revealed a higher incidence of multivessel disease in the elderly. To conclude, thrombolytic therapy is safe and effective even in older individuals.