JACC. Case reports · 2026
Purulent Pericarditis Presenting With Abnormal Electrocardiogram Consistent With STEMI.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Zarghami Mehrdad, Garg Natasha, Okan Tetyana, Wazir Hina, Hana Fadi, Abdulhadi Tarek, Hussein Mohammed, Mangla Aditya, Lasic Zoran
Аннотация
BACKGROUND: Purulent pericarditis is a rare, life-threatening condition accounting for <1% of pericardial disease.
CASE SUMMARY: A 57-year-old woman with active intravenous drug use and poorly controlled type 2 diabetes presented with chest pain and inferolateral ST-segment elevations. Emergent coronary angiography revealed nonobstructive coronary artery disease. Subsequent echocardiogram revealed a large pericardial effusion with tamponade physiology. Pericardiocentesis drained 600 mL of purulent fluid positive for methicillin-sensitive Staphylococcus aureus.
DISCUSSION: This case illustrates the diagnostic challenge of "pseudo-STEMI" in the setting of purulent pericarditis and underscores the importance of a rigorous diagnostic approach when angiography fails to identify a culprit lesion, necessitating a broader differential to determine the true underlying pathology.
CASE SUMMARY: A 57-year-old woman with active intravenous drug use and poorly controlled type 2 diabetes presented with chest pain and inferolateral ST-segment elevations. Emergent coronary angiography revealed nonobstructive coronary artery disease. Subsequent echocardiogram revealed a large pericardial effusion with tamponade physiology. Pericardiocentesis drained 600 mL of purulent fluid positive for methicillin-sensitive Staphylococcus aureus.
DISCUSSION: This case illustrates the diagnostic challenge of "pseudo-STEMI" in the setting of purulent pericarditis and underscores the importance of a rigorous diagnostic approach when angiography fails to identify a culprit lesion, necessitating a broader differential to determine the true underlying pathology.