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Srpski arhiv za celokupno lekarstvo 2019 Volume 147, Issue 1-2, Pages: 74-77
https://doi.org/10.2298/SARH171013068S
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Severe short-lasting left ventricular dysfunction associated with a respiratory infection

Stanković Ivan ORCID iD icon (University Clinical Hospital Center Zemun, Faculty of Medicine, Department of Cardiology, Belgrade)
Obradović Gojko D. (University Clinical Hospital Center Zemun, Faculty of Medicine, Department of Cardiology, Belgrade)
Vidaković Radosav (University Clinical Hospital Center Zemun, Faculty of Medicine, Department of Cardiology, Belgrade)
Maksimović Ružica (University Clinical Center of Serbia, Faculty of Medicine, Center for Radiology and Magnetic Resonance Imaging, Belgrade)
Ilić Ivan (University Clinical Hospital Center Zemun, Faculty of Medicine, Department of Cardiology, Belgrade)
Putniković Biljana (University Clinical Hospital Center Zemun, Faculty of Medicine, Department of Cardiology, Belgrade)
Nešković Aleksandar N. ORCID iD icon (University Clinical Hospital Center Zemun, Faculty of Medicine, Department of Cardiology, Belgrade)

Introduction. Since clinical and electrocardiographic features of various cardiac disorders may overlap, the differential diagnosis of left ventricular (LV) dysfunction may be difficult even for the most experienced physicians. Recent advances in cardiac imaging may help clinicians to establish an accurate diagnosis and initiate adequate treatment. The aim of this case report is to raise awareness of a very short-lasting LV dysfunction during respiratory infections and to underline the importance of multimodality imaging in this clinical setting. Case outline. A previously healthy 37-year-old male presented with atypical chest pain and ST-segment elevation in the inferolateral leads during severe mental stress and acute respiratory infection. Acute myocardial infarction, myocarditis, coronary vasospasm and stress cardiomyopathy were all considered as a differential diagnosis. A rapid onset of severe LV dysfunction and a complete recovery within 4 days was detected by echocardiography and further evaluated by multimodality imaging, including multislice computed tomography and cardiac magnetic resonance imaging. Conclusion. Severe, but very short-lasting LV dysfunction may be triggered by various causes, including upper respiratory tract infections. Since the symptoms of respiratory infections may obscure those of LV dysfunction, myocardial dysfunction in these patients may go undetected with possible serious consequences.

Keywords: chest pain, ST-segment elevation, transient left ventricular dysfunction