Outcome after thrombolytic therapy of nine cases of myopericarditis misdiagnosed as XXXX .

@entity662 @entity1 @entity2002 @entity2294 @entity908 @entity2396 @entity299 @entity583 @entity943 @entity65
Anecdotal reports have suggested that @entity65 may occur if thrombolytic therapy is performed in cases of @entity2396 misdiagnosed as acute @entity583 . From 1980 to 1993, 47 cases of myopericarditis mimicking @entity583 have been admitted to our institution. The misdiagnosis was made because of clinical onset characterized by a typical @entity662 , and/or localized ST segment elevation. Since 1987, nine (9/9 males, age 40 +/- 14 years) out of the 47 @entity1 (19%) have been treated with a thrombolytic agent (streptokinase 4/9, rt-PA 5/9) followed by intravenous heparin. This treatment was started during the pre-hospital phase (2/9) and while in hospital (7/9). No pericardial rub was present; ST segment elevation was mainly localized in inferior and lateral leads; no Q wave developed; median @entity908 kinase rise was 268 units (range 38 to 1280), and only one @entity1 had a small pericardial effusion. The mean level of @entity2002 after thrombolysis was 1.72 g.l-1 (range 0.10 to 4.50). In all cases, typical ECG changes were present suggesting @entity2396 with a subsequent return to a normal ECG. No severe @entity299 or @entity943 occurred; only one @entity1 developed a @entity2294 . Cardiac catheterizations (coronary and left ventricular angiographies) were normal when performed (5/9). Long-term follow-up (mean 46 +/- 29 months) was favourable without any coronary events. In conclusion, thrombolytic therapy was uncomplicated in our @entity1 with myopericarditis simulating evolving @entity583 .
