A Case of ST-Segment Elevation Myocardial Infarction Mimicking Stress-Induced Cardiomyopathy

Introduction Symptoms of ST-segment elevation myocardial infarction (STEMI) is caused by vulnerable plaque, and is described by typical chest pain, ST change under electrocardiogram (ECG), elevated cardiac enzymes, along with wall motion abnormality under echocardiographic findings. Although the incidence of stress-induced cardiomyopathy (SICM) is low according to Cangella et al. it shares similar clinical symptoms with STEMI except for echocardiographic findings. Under echocardiogram, the differential diagnoses are made, with SICM typically showing regional systolic dysfunction of the left ventricular walls with hypokinesis of the mid-apical segments and hyperkinesis of the basal segment. However, rare cases of apical sparing and other wall motion involvement have also been cited. Thus, without precaution, these two diseases may be difficult to differentiate, and one may overlook the proper management of the two different diseases. We have experienced an STEMI patient showing echocardiographic findings consistent with SICM. The purpose of this report is to arouse clinicians about how important it is to make proper diagnosis and management in this circumstance.