ABSTRACT
Acute myocarditis may mimic an infarction. Aim is to describe a case series of peculiar myocarditis. From 1997 to 2003, 11 male patients (age 17-39 years) were admitted with diagnosis of acute myocardial infarction, localized ST segment elevation and minimal enzyme release. Ten patients had fever in the 3 days prior to admission. Eight patients underwent coronary angiography showing normal coronary arteries. All remained asymptomatic at long term follow-up. In conclusion, myocarditis with ST elevation myocardial infarction presentation is an acute benign syndrome especially frequent in young males.
Subject(s)
Myocardial Infarction/diagnosis , Myocarditis/diagnosis , Acute Disease , Adolescent , Adult , Diagnosis, Differential , Electrocardiography , Humans , MaleABSTRACT
BACKGROUND: Pulmonary embolism (PE) afflicts millions of individuals worldwide. Electrocardiography along with chest X-ray and arterial blood gas analysis represent the basic examinations to reinforce the clinical suspicion of PE. We describe the electrocardiographic (ECG) features in a series of patients with PE and a critical clinical presentation. METHODS: We report the ECG findings registered at baseline, 48 hours after admission and on continuous ECG monitoring in 51 patients with PE and critical clinical conditions. RESULTS: At admission, the following parameters were recorded: an S1Q3 pattern in 34 patients, a "septal embolic pattern" in 27, anterior lead T-wave inversion in 8, and a new right bundle branch block in 7. At 48 hours after admission a trend toward a regression of the S1Q3 and "septal embolic" patterns was noted together with evident T-wave inversion in the anterior leads. During continuous ECG monitoring no major arrhythmias were recorded, even in case of cardiopulmonary arrest. CONCLUSIONS: Critical PE induces transient ECG abnormalities reflecting right ventricular overload and/or strain. The patient's clinical status is usually not complicated by major ventricular arrhythmias, not even in case of cardiopulmonary arrest.