ELECTROCARDIOGRAPHIC DIAGNOSTIC DIFFICULTIES IN A PATIENT WITH OBSTRUCTIVE HYPERTROPHIC CARDIOMYOPATHY AND ACUTE PERICARDITIS - CASE REPORT
We present the case of a male patient aged 38 years, athlete, without known cardiovascular history who has presented in the emergency room, sent from a city hospital with suspected acute coronary syndrome based on electrocardiographic appearance. The patient presented a faint at medium effort, accompanied by sweating, recent cough, anterior parietal chest pain. BP = 100/60 mmHg, FC = 60/min, rhythmic heart sounds, systolic murmur. The resting electrocardiogram showed changes in repolarization (important depression ST segment and negative T waves) in the anterior-lateral territory and short PR interval. Echocardiography documented obstruction of LV outflow tract and a small amount of pericardial fluid. Based on electrocardiographic appearance is discussed the differential diagnosis of obstructive hypertrophic cardiomyopathy and possible associated pre-excitation, with an acute coronary syndrome and pericarditis, as well as the particularities of the case.