AI Article Synopsis
- Acute ST elevation myocardial infarction (STEMI) is usually caused by blocked coronary arteries but can be mimicked by eosinophilic granulomatosis with polyangiitis (EGPA) myocarditis.
- A 44-year-old woman experiencing chest pain and shortness of breath was found to have unobstructed coronary arteries, leading to a diagnosis of EGPA myocarditis through various imaging and testing methods.
- The patient significantly improved with steroid and cyclophosphamide treatment, highlighting the importance of cardiac magnetic resonance imaging (CMR) in diagnosing rare cases that resemble STEMI.
Article Abstract
Background: Acute ST elevation myocardial infarction (STEMI) is a medical emergency and is most commonly due to atherosclerotic plaque rupture and occlusion of coronary vessels. This case demonstrates that eosinophilic granulomatosis with polyangiitis (EGPA) myocarditis can mimic acute STEMI.
Case Summary: A 44-year-old woman presented with acute chest pain, shortness of breath, and collapse with ST elevation on electrocardiography. Coronary angiogram showed unobstructed coronaries and chest film revealed left-sided consolidation. Together with a thorough history, serum eosinophilia, cardiac magnetic resonance (CMR), and computated tomography imaging, the patient was diagnosed with acute EGPA myocarditis. She responded tremendously to steroid and cyclophosphamide immunosuppression and subsequent CMR imaging demonstrated complete resolution of myocarditis.
Discussion: CMR played a crucial role in the diagnosis and follow-up of this rare presentation. In patients who present as a STEMI but show unobstructed coronary vessels, EGPA may be a possible diagnosis.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8183649 | PMC |
| http://dx.doi.org/10.1093/ehjcr/ytz161 | DOI Listing |
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