Infant acute myocarditis mimicking acute myocardial infarction

Authors

  • Maher Jedidi Farhat Hached University Hospital. Department of Legal Medicine
  • Samia Tilouche Farhat Hached University Hospital. Department of Pediatrics
  • Tasnim Masmoudi Farhat Hached University Hospital. Department of Legal Medicine
  • Maha Sahnoun Farhat Hached University Hospital. Department of Legal Medicine
  • Youssef Chkirbène Farhat Hached University Hospital. Department of Legal Medicine
  • Sarra Mestiri Farhat Hached University Hospital. Department of Pathology
  • Lamia Boughamoura Farhat Hached University Hospital. Department of Pediatrics
  • Mohamed Ben Dhiab Farhat Hached University Hospital. Department of Legal Medicine
  • Mohamed Kamel Souguir Farhat Hached University Hospital. Department of Legal Medicine

DOI:

https://doi.org/10.4322/acr.2016.052

Keywords:

Myocarditis, Myocardial Infarction, Diagnosis, Differential, Infant Death

Abstract

Myocarditis is an inflammatory disease of the myocardium with heterogeneous clinical manifestations and progression. In clinical practice, although there are many methods of diagnosis of acute myocarditis, the diagnosis remains an embarrassing dilemma for clinicians. The authors report the case of 9-month-old infant who was brought to the Pediatric Emergency Department with sudden onset dyspnea. Examination disclosed heart failure and resuscitation was undertaken. The electrocardiogram showed an ST segment elevation in the anterolateral leads with a mirror image. Cardiac enzyme tests revealed a significant elevation of troponin and creatine phosphokinase levels. A diagnosis of acute myocardial infarction was made, and heparin therapy was prescribed. The infant died on the third day after admission with cardiogenic shock. The autopsy showed dilatation of the ventricles and massive edema of the lungs. Histological examinations of myocardium samples revealed the presence of a marked lymphocytic infiltrate dissociating myocardiocytes. Death was attributed to acute myocarditis. The authors call attention to the difficulties of differential diagnosis between acute myocarditis and acute myocardial infarction especially in children, and to the important therapeutic implications of a correct diagnosis

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Published

2016-12-11

How to Cite

Jedidi, M., Tilouche, S., Masmoudi, T., Sahnoun, M., Chkirbène, Y., Mestiri, S., Boughamoura, L., Dhiab, M. B., & Souguir, M. K. (2016). Infant acute myocarditis mimicking acute myocardial infarction. Autopsy and Case Reports, 6(4), 15-19. https://doi.org/10.4322/acr.2016.052

Issue

Section

Article / Autopsy Case Report