Acute Myocarditis Mimicking Inferior Wall Myocardial Infarction: A Case Report

Abstract

Introduction: Myocarditis is an inflammation of the heart muscle. Its clinical presentation can vary from asymptomatic cases to acute heart failure that may mimic acute coronary events. Due to similarities in symptoms such as chest pain, elevated cardiac enzymes and electrocardiographic (ECG) changes, acute myocarditis can occasionally present as acute myocardial infarction (AMI). A high index of suspicion is often required for the appropriate management of these patients, as different treatment protocols are required for each condition. Case Report: We present the case of a young woman with sudden onset of chest pain associated with ECG changes suggestive of acute inferior wall myocardial infarction (AWMI). Subsequent investigations ruled out AWMI and led to the diagnosis of a herpes viral myocarditis. She was treated and made a rapid recovery. Understanding the similarities and differences between myocarditis and myocardial infarction can help improve diagnostic criteria and treatment protocols, ultimately leading to better patient care. Conclusion: Acute myocarditis can clinically resemble acute coronary syndrome (ACS) and a high degree of suspicion is required to differentiate between the two. Young patients presenting with ST elevation on ECG mimicking acute myocardial infarction could have other differential diagnoses such as myocarditis, MINOCA, coronary spasm, etc. and it is important to consider all of these differential diagnoses, especially in the absence of risk factors, as the management of each of these conditions is different.