Acute coronary syndrome in young patients with atypical symptoms

• Main Authors: Gustavo Daher, Henrique Lane Staniak, Márcio Sommer Bittencourt, Rodolfo Sharovsky
• Format: Article
• Language: English
• Published: University of São Paulo 2011-03-01
• Series: Autopsy and Case Reports
• Subjects: Chest paint; Acute coronary syndromes; Tomography; Angiography/methods; Myocarditis.
• Online Access: http://www.revistas.usp.br/autopsy/article/view/36412

Evaluation of acute chest pain can be extremely difficult and challenging. This diagnosis comprehends several causes, including benign and potentially lethal causes. Most of the time, the diagnosis can be done with the history and ordinary tests such as electrocardiogram, chest x-ray and myocardial enzymes. The coronary angiotomography is a new tool that can safely rule out acute coronary syndrome, being performed in patients with low to middle probability of acute coronary syndrome. The present report describes a young woman that presented to the emergency unit with atypical chest pain and myocardial enzyme elevation. Miocarditis was the initial diagnosis The patient was submited to a coronary angiotomography with late enhancement research. The coronary angiotomography demonstrated zero calcium score with a high degree stenosis in the coronary descending artery and late enhancement in anterior wall demonstrating myocardial necrosis. It was performed coronary catheterization and angioplasty afterwards.