Lee Phong Teck, See Chai Keat, Chiam Paul Toon Lim, Lim Soo Teik
Department of Cardiology, National Heart Centre Singapore, 17 Third Hospital Avenue, Singapore 168752.
Singapore Med J. 2015 Jan;56(1):e1-3. doi: 10.11622/smedj.2015015.
Pericarditis and myocarditis are characterised by electrocardiographic changes and elevated cardiac enzymes, respectively, and patients with perimyocarditis often complain of chest discomfort. These findings are nonspecific and often lead to diagnostic difficulties, as ST-elevation myocardial infarction commonly presents in a similar fashion. Clinical differentiation between perimyocarditis and myocardial infarction are especially important because adverse side effects can occur if reperfusion therapy is administered for a patient with acute pericarditis or if a diagnosis of acute myocardial infarction is missed. We herein describe a case of perimyocarditis with ST elevation and raised cardiac markers, which led to two emergency coronary angiographies that were subsequently found to be normal. We include the three serial electrocardiographies (ECGs) performed to show the characteristic features of perimyocarditis and further discuss the importance of identifying typical and atypical ECG features of pericarditis.
心包炎和心肌炎分别以心电图改变和心肌酶升高为特征，而心肌心包炎患者常主诉胸部不适。这些表现是非特异性的，常常导致诊断困难，因为ST段抬高型心肌梗死通常也以类似方式呈现。心肌心包炎和心肌梗死的临床鉴别尤为重要，因为对急性心包炎患者进行再灌注治疗或漏诊急性心肌梗死都可能产生不良副作用。我们在此描述一例伴有ST段抬高和心肌标志物升高的心肌心包炎病例，该病例导致进行了两次急诊冠状动脉造影，结果随后发现均正常。我们纳入了三份连续的心电图以显示心肌心包炎的特征，并进一步讨论识别心包炎典型和非典型心电图特征的重要性。
