Case Report

Fulminant Myocarditis Presenting with Wide Complex Tachycardia

Authors: Mark A. Stankewicz, MD, Stephen D. Clements, Jr, MD

Abstract

Fulminant myocarditis is an uncommon diagnosis characterized by cardiac failure preceded by symptoms of a viral illness. Presentation can frequently mimic acute myocardial infarction. The electrocardiographic changes are frequently nonspecific, but include ST segment elevation and T wave changes, as well as conduction abnormalities. We report the case of a patient with fulminant myocarditis that presented with sinus rhythm, a conduction system abnormality, and severe ST segment elevation mimicking ventricular tachycardia. Myocarditis should be considered in young persons with unexplained heart failure and similar electrocardiographic abnormalities.


Key Points


* Myocarditis can have a rapidly progressive course causing cardiac failure and death.


* Differentiation between acute myocardial infarction and myocarditis is not always straightforward, but is important because of different treatments and prognoses.


* Fulminant myocarditis should be considered in the differential diagnosis of wide complex tachycardia.

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