Myopericarditis diagnosed by a 64-slice coronary CT angiography "triple rule out" protocol.

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This article has been peer reviewed. It was published in: International journal of emergency medicine

Volume 3, Issue 4, August 2010, Pages 447-9.

The published version is available at DOI: 10.1007/s12245-010-0210-z. Copyright © Springer


We report a case of myopericarditis in a 30-year-old male complaining of shortness of breath. In an emergency department (ED) setting, the symptoms of myopericarditis may overlap with many disease entities and can be a challenging diagnosis to make. However, with the use of a 64-section coronary CT angiography in a "triple rule out" (TRO) protocol, we were able to detect a large pericardial effusion surrounding the heart and moderate global hypokinesis in the setting of normal-sized heart chambers and normal coronary arteries. We were further able to exclude pulmonary embolism and thoracic dissection. This is the first reported case of diagnosing myopericarditis using a TRO protocol. It demonstrates the usefulness of TRO in making an emergent diagnosis of myopericarditis while excluding other life-threatening diseases that can lead to earlier appropriate ED disposition and care.

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