C83 BEHIND MYOCARDITIS DIAGNOSIS

Abstract Background Myocarditis is an inflammatory disease of myocardium, with a wide range clinical presentation. may mimic acute coronary syndrome (ACS), but it also possible overlap between these two different syndromes, as we considered the close relationship systemic condition and atherosclerotic plaque instability Case report: We report case 29 years old man admitted to emergency department for burning chest pain changed breathing in positions body, associated dyspnea on mild–moderate exertion. Symptoms had begun arise week earlier, flu–like symptoms, got worse last 48 hours. In his history patient reports: previous myocarditis, dyslipidemia, hyperhomocysteinemia, overweight, family cardiovascular COVID infection. Blood tests found rise Troponin I HS. Electrocardiogram showed diphasic T wave antero–lateral leads. An echocardiogram left ventricle normal cavitary dimensions preserved global systolic function, apical segment interventricular septum inferior wall hypokinetic; minimal pericardial detachment leaflet hyperecogenicity. The was Cardiology ward, he given medical therapy colchicina 0.5 mg 1 cp x 2/die AcetylSalicilic Acid 1000 3 /die. Cardiac Magnetic Resonance epi–mesocardial LGE lateral distal segments, compatible myocarditis. CT angiography exhibited calcified determining partial caliber reduction anterior descending proximal segment, its portion appeared ectatic, hypodense poorly dulled likely steno–occlusion. Therefore, performed that revealed artery occluded at tract, OCT erosion thrombotic apposition mid–proximal tract vessel. Finally, results instrumental exams, second antiplatelet agent, hypolipidemic drug were added Discussion According cardiac MRI findings angiography, hypothesized picture triggered by unstable plaque, induced massive myocardial inflammation related infections infarction has been already established COVID–19 patients