New York University Langone Health|Bellevue Hospital Center, New York, NY.
J Emerg Med. 2020 Nov;59(5):e183-e185. doi: 10.1016/j.jemermed.2020.04.013. Epub 2020 Jun 11.
Myocarditis is a rare sequelae of acute myeloid leukemia (AML) and typically presents after the initial diagnosis of AML has been made.
We present the case of a 37-year-old female who came to the emergency department with chest pain, ST elevations on electrocardiogram, and a positive point-of-care troponin. She was brought emergently to the cardiac catheterization laboratory. After a negative catheterization, blasts were noted on the complete blood count, ultimately leading to the diagnosis of AML, with myopericarditis as the presenting manifestation. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case highlights the need for emergency physicians to consider a broad differential for chest pain, especially in those who do not fit into the prototypical patient with acute coronary syndrome.
心肌炎是急性髓系白血病（AML）的罕见后遗症，通常在 AML 的初始诊断后出现。
我们报告了一例 37 岁女性患者，因胸痛、心电图 ST 段抬高和即时肌钙蛋白阳性而来到急诊科。她被紧急送往心脏导管实验室。在导管检查阴性后，全血细胞计数中发现了原始细胞，最终导致 AML 的诊断，其表现为心肌心包炎。
为什么急诊医生应该注意到这一点？：本病例强调了急诊医生需要考虑广泛的胸痛鉴别诊断，特别是对于那些不符合急性冠状动脉综合征典型患者的情况。
