Infarction-like course of myocarditis: a clinical case

The use of coronary angiography as a method for diagnosing coronary lesions in myocardial infarction (MI) in order to determine further management tactics has become widespread in recent years. In case of no significant atherosclerotic changes in the coronary arteries (CA) according to the coronary angiography in a patient with probable clinical and laboratory-instrumental signs of MI, it is necessary to conduct a thorough analysis of clinical and instrumental data in search of the true cause of the existing changes. For such clinical cases, the term myocardial infarction (MI) with non-obstructive coronary arterie (MINOCA) and an algorithm for further diagnostic search are proposed. Myocarditis often occurs under the guise of minoca, but the difficulties of differential diagnosis in practice are associated to the fact that the clinical course of myocarditis is very variable and nonspecific, and with an anginal-like pain syndrome, infarction-like changes in the electrocardiogram and an increase in the cardiospecific enzyme levels, the diagnosis of MI is established. The timely initiation of treatment, the determination of the volume of specialized care for both MI and myocarditis depends on the correct interpretation of complaints, the interpretation of symptoms and data from laboratory and instrumental tests. In addition, a correctly established diagnosis will avoid the prescription of drugs with action often associated with the development of serious complications. The article presents a clinical case of a patient with acute myocarditis, most likely of viral origin (unspecified), occurring under the guise of MINOCA.