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酷似急性心肌梗死的急性结核性心肌心包炎:一例报告及文献复习

Acute tuberculous myopericarditis mimicking acute myocardial infarction: A case report and literature review.

作者信息

Ren Manyi, Zhang Chunsheng, Zhang Xiaojuan, Zhong Jingquan

机构信息

Department of Cardiology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, Shandong 250014, P.R. China.

Department of Cardiology, Shandong Provincial Chest Hospital, Jinan, Shandong 250013, P.R. China.

出版信息

Exp Ther Med. 2016 Jun;11(6):2373-2378. doi: 10.3892/etm.2016.3187. Epub 2016 Mar 24.

Abstract

A number of cases of acute myopericarditis mimicking acute myocardial infarction (AMI) have previously been reported in the literature. However, to the best of our knowledge, such a case resulting from infection has not previously been described. The present study reports the case of a 21-year-old male patient presenting with acute chest pain, in whom focal ST-segment elevation and elevated cardiac enzymes mimicked a diagnosis of AMI. However, acute tuberculous myopericarditis was diagnosed on the basis of a variety of imaging examinations, laboratory tests, as well as the changes observed in electrocardiograms (ECGs) and in the cardiac enzyme levels. The case highlights the importance of a detailed collection of medical history, comprehensive explanations of serial ECGs, thoracic computed tomography, echocardiogram and coronary angiography in the diagnosis and differentiation of acute tuberculous myopericarditis mimicking AMI.

摘要

此前已有多篇文献报道了一些酷似急性心肌梗死(AMI)的急性心肌心包炎病例。然而,据我们所知,此前尚未有因感染导致此类病例的描述。本研究报告了一名21岁男性患者,该患者表现为急性胸痛,其局部ST段抬高及心肌酶升高酷似AMI的诊断。然而,通过各种影像学检查、实验室检查以及心电图(ECG)和心肌酶水平的变化,最终诊断为急性结核性心肌心包炎。该病例突出了详细收集病史、对系列心电图、胸部计算机断层扫描、超声心动图和冠状动脉造影进行全面解读,对于诊断和鉴别酷似AMI的急性结核性心肌心包炎的重要性。

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