<症例>臨床上急性心筋梗塞と鑑別困難であった急性心膜心筋炎の1例

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  • <Case Reports>A case of acute myopericarditis which was difficult to differentiate from acute myocardial infarction

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We report a case of acute myopericarditis which was difficult to differentiate from acute myocardial infarction in early hospital days. A 19 year-old man was admitted to our CCU under the diagnosis of acute inferior myocardial infarction because of chest pain without radiation to elsewhere. He had a recent upper respiratory tract infection, but no pericardial friction rub and no pericardial effusion. ECG showed a localized ST elevation in leads II, III, _aV_F, V_5 and V_6. Serum enzymes and white blood cell count were elevated. The 2D-echocardiogram and left ventriculogram showed posterior and inferior wall motion abnormalities. Radionuclide imaging was normal. Coronary arteriogram showed no significant stenosis. ECG showed inversion of T wave, but no abnormal Q wave and no depressed R wave. The regional wall motion abnormality rapidly improved. Diffuse infiltration of inflammatory cells revealed by the endomyocardial biopsy confirmed the diagnosis as acute myopericarditis. It seemed that a severe inflammation process occurred in the posterior and the inferior wall.

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