Located ST-Segment Elevation as Atypical Presentation of Acute Perimiocarditis

ABSTRACT

We report the case of a young patient admitted to the emergency room with precordial pain. Admission electrocardiogram identified ST-segment elevation located on the side wall associated with “mirror” image, with highly elevated cardiac enzymes, suggesting a diagnosis of coronary syndrome with ST-segment elevation. Echocardiogram revealed pericardial effusion with preserved ejection fraction and absence of segmental abnormalities, thus suggesting acute pericarditis with myocardial involvement. Cardiac magnetic resonance was performed, showing non-ischemic late enhancement, confirming the diagnosis of perimiocarditis. This is an uncommon situation in clinical practice and deserves greater understanding and attention by the doctors working in emergency rooms.