Comparision between Myopericarditis and ST-Segment Elevation Myocardial Infarction: A Case Report
Nabil Laktib *
Cardiac Intensive Care Unit of the Cardiology Center, Mohammed V Military Teaching Hospital, Rabat, Morocco.
Mehdi Ayoub Laaroussi
Cardiac Intensive Care Unit of the Cardiology Center, Mohammed V Military Teaching Hospital, Rabat, Morocco.
Hicham Faliouni
Cath-Lab of the Cardiology Center, Mohammed V Military Teaching Hospital, Rabat, Morocco.
Ilyasse Asfalou
Department of the Non-Invasive Cardiac Exploration, Cardiology Center, Mohammed V Military Teaching Hospital, Rabat, Morocco.
Aatif Benyass
Mohammed V Military Teaching Hospital, Rabat, Morocco.
Zouhair Lakhal
Cardiac Intensive Care Unit of the Cardiology Center, Mohammed V Military Teaching Hospital, Rabat, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Myopericarditis is an inflammatory disease affecting both the pericardial sac and the myocardium. Its presentation is typically similar to pericarditis syndrome, with myocardial involvement being more subtle or secondary in nature. Distinguishing between myopericarditis and myocardial infarction can be difficult, as the clinical, electrical and biological presentations of the two conditions can be similar. The study reports the case of a young patient who presented to the emergency department with acute chest pain. The electrocardiogram showed ST elevation in the septal and lateral leads with subtle reciprocal changes. The patient was initially mistakenly treated for coronary syndrome with ST-segment elevation, then diagnosed with myopericarditis on magnetic resonance imaging. Features such as young age, recent influenza-like illness, absence of cardiovascular risk factors and CRP/troponin ratio may point to myopericarditis rather than myocardial infarction. Early and accurate differentiation is essential to ensure optimal patient care and improve clinical outcomes. Cardiac magnetic resonance imaging (MRI) played a pivotal role in confirming the diagnosis.
Keywords: Myopericarditis, myocardial infarction, misdiagnosis, medical reasoning