Zhang Tao, Miao Wei, Wang Shixuan, Wei Min, Su Guohai, Li Zhenhua
Department of Orthopedics, Jinan Central Hospital, Jinan, Shandong 250013, P.R. China.
Department of Cardiology, Jinan Central Hospital, Jinan, Shandong 250013, P.R. China.
Exp Ther Med. 2015 Aug;10(2):459-464. doi: 10.3892/etm.2015.2576. Epub 2015 Jun 12.
The present study describes the case of a young man aged 22 who had acute retrosternal pain, elevated cardiac markers and electrocardiographic ST-T changes, which led to an original misdiagnosis of acute myocardial infarction. The patient underwent immediate coronary angiography, which revealed normal coronary arteries. Finally, the diagnosis of viral myocarditis was made on consideration of his fever, scattered red dots on his arms and legs and other auxiliary examination results obtained in the following days, which were supportive of the diagnosis. The patient improved on antiviral and myocardial protection therapy and was discharged 2 weeks later. Viral myocarditis is a common disease with a variable natural history. It remains challenging for doctors to differentiate between acute myocarditis and myocardial infarction, particularly in the early stages. A diagnosis of myocarditis should be made on the basis of synthetic evaluation of the evidence, including medical history, clinical presentation and results of the available auxiliary tests, in order to provide guidelines for treatment.
本研究描述了一名22岁年轻男性的病例,该患者有急性胸骨后疼痛、心脏标志物升高及心电图ST-T改变,最初被误诊为急性心肌梗死。患者接受了急诊冠状动脉造影,结果显示冠状动脉正常。最终,综合考虑患者发热、四肢散在红点以及随后几天获得的其他辅助检查结果,确诊为病毒性心肌炎,这些结果支持该诊断。患者接受抗病毒及心肌保护治疗后病情好转,2周后出院。病毒性心肌炎是一种常见疾病,其自然病程多变。医生区分急性心肌炎和心肌梗死仍具有挑战性,尤其是在疾病早期。心肌炎的诊断应基于包括病史、临床表现及现有辅助检查结果在内的证据综合评估,以便为治疗提供指导。