Omar Hesham R, Fathy Ahmed, Rashad Rania, Elghonemy Mohamed
Department of Cardiology, Cairo University Hospital, Cairo, Egypt.
Int Arch Med. 2009 Dec 9;2(1):37. doi: 10.1186/1755-7682-2-37.
Although acute pericarditis has charachteristic electrocardiographic (ECG) findings that differentiate it from acute ST segment elevation myocardial infarction (MI); in certain cases diagnosis is somewhat difficult especially when the ECG reveals focal instead of diffuse changes and moreover when pericarditis is associated with an underlying myocarditis causing elevation of the cardiac biomarkers therefore increasing the difficulty in differentiating between both enteties. This is especially important because adverse lethal side effect can occur if thrombolytic therapy is administered for a patient with acute pericarditis, or if a diagnosis of transmural MI is missed. In this case report we are describing an 18 year old male patient who presented with an acute onset of severe chest pain associated with focal ECG changes and elevated cardiac enzymes mimicking transmural MI. This report aims to sensitize readers to this debate and create awareness among cardiologists and intensivists with both presentations and how to reach an accurate diagnosis.
虽然急性心包炎具有特征性的心电图（ECG）表现，可将其与急性ST段抬高型心肌梗死（MI）区分开来；但在某些情况下，诊断有些困难，尤其是当心电图显示的是局灶性而非弥漫性改变时，此外，当心包炎与潜在的心肌炎相关联导致心脏生物标志物升高时，这就增加了区分这两种疾病的难度。这一点尤为重要，因为如果对急性心包炎患者进行溶栓治疗，或者漏诊透壁性心肌梗死，可能会出现致命的不良副作用。在本病例报告中，我们描述了一名18岁男性患者，他突发严重胸痛，伴有局灶性心电图改变和心脏酶升高，酷似透壁性心肌梗死。本报告旨在引起读者对这一争议的关注，并提高心脏病专家和重症监护医生对这两种表现的认识以及如何做出准确诊断。
