Abstract:

An old male patient visited the hospital due to shortness of breath and palpitation for 6 h, with fever 3 days before and pump failure at admission. Having no risk factor of coronary diseases such as hypertension, diabetes mellitus and obesity, with ST-T changes and abnormal Q wave on ECG, the signs were compatible with those of acute anterior wall myocardial infarction, while the characteristics of cardiac biomarkers (significant increase in Troponin I and creatine kinase's isoform, and normal creatine kinase) were not in accordance with those of acute myocardial infarction. Emergency angiography was performed, which indicated normal coronary artery, normal pulmonary artery and global systolic dysfunction of left ventricle. The diagnosis of acute severe myocarditis was established, and intra-aortic balloon pump (IABP) was employed to provide hemodynamic support. Severe myocarditis mimicking acute myocardial infarction may be fatal, and can be easily misdiagnosed. Careful analysis of clinical manifestations, early diagnostic angiography and possible IABP placement are important for the successful treatment.

Key words: severe myocarditis, acute myocardial infarction, intra-aortic balloon counterpulsation