Ata Fateen, Chaudhry Hammad Shabir, Bilal Ammara Bint I, Lopez Maria Delas Nieves Montoro
Department of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
Department of Radiology, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
Heart Views. 2020 Oct-Dec;21(4):284-288. doi: 10.4103/HEARTVIEWS.HEARTVIEWS_82_20. Epub 2021 Jan 14.
Myopericarditis, which is an inflammatory process involving the myocardium and pericardium, is not a rare condition encountered in cardiac emergencies. Rarely though, it can give an acute myocardial infarction picture on electrocardiogram (ECG), leading to urgent angiography. More rarely, it can be associated with atrioventricular (AV) dissociation, which is a condition of dyssynchrony of electrical activity between atria and ventricles. We present the case of a young female, who presented with severe chest pain, associated with ST elevation in anterior leads of ECG and raised troponins, necessitating urgent coronary angiography. Normal coronaries led to further evaluation, including cardiac magnetic resonance imaging, which established the diagnosis of myopericarditis. The patient had AV dissociation secondary to myopericarditis. With the treatment of myopericarditis and transvenous pacing, the patient stabilized and was subsequently discharged asymptomatic.
心肌心包炎是一种累及心肌和心包的炎症过程，在心脏急症中并非罕见。不过，它很少会在心电图（ECG）上呈现急性心肌梗死的表现，从而导致紧急血管造影。更罕见的是，它可伴有房室（AV）分离，这是一种心房和心室电活动不同步的情况。我们报告一例年轻女性病例，该患者出现严重胸痛，伴有心电图前壁导联ST段抬高和肌钙蛋白升高，需要紧急进行冠状动脉造影。冠状动脉正常促使进一步评估，包括心脏磁共振成像，最终确诊为心肌心包炎。该患者因心肌心包炎继发AV分离。经过心肌心包炎治疗和经静脉起搏，患者病情稳定，随后无症状出院。
