Acute Chest Pain in a 70-Year-Old Woman at CNHU-HKM Cotonou: Morbid Association or Diagnostic Wandering

Abstract

Objectives: Challenging differential diagnosis. Background: Acute myopericarditis and ACS STEMI share the presenting triad of acute chest pain, ST segment changes, and elevated cardiac enzymes. Differentiating is not always straightforward. Case Report: We reported the clinical observation of a 70-year-old woman admitted into cardiology intensive care for acute chest pain with electrocardiographic abnormalities suggestive of acute coronary syndrome with ST elevation (ACS STEMI). Pharmacological myocardial revascularization was done. Secondary evolution in the absence of initial coronary angiography is compatible with a myopericarditis of favorable evolution under empiric antibiotherapy. Coronarography performed remotely reveals a significant stenosis of the proximal and middle circumflex. Percutaneous angioplasty was successfully performed. Conclusion: In patients with acute chest pain, ST segment changes and elevated cardiac enzymes, coronary angiography can be useful in differential diagnosis.