{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T08:11:04Z","timestamp":1775549464619,"version":"3.50.1"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Egypt Heart J"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Myopericarditis is uncommon but important to consider in patients presenting with chest pain. It most commonly is caused by a viral infection. Myopericarditis involves both myocardial injury and pericardial sac inflammation, thus may benefit from close monitoring and expedited treatment. It can present like pericarditis with chest pain, cold-type symptoms, diffuse ST elevations and PR depressions on electrocardiogram (ECG), and pericardial effusion on ultrasound. Risk stratification depends on case severity. More severe cases of myopericarditis can demonstrate elevated troponins and myocardial involvement, including potential left ventricular dysfunction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We describe an 81-year-old male patient with three days of pleuritic chest pain, dyspnea on exertion, and upper respiratory infection symptoms. He was evaluated by cardiology due to diffuse ST elevations on his ECG but did not have reciprocal changes, making acute coronary syndrome (ACS) less likely. His workup showed elevated inflammatory markers and elevated high-sensitivity troponin levels, indicating myocardial injury and distinguishing his diagnosis from pericarditis. His respiratory viral panel was negative. Bedside ultrasound showed a small pericardial effusion and moderately reduced ejection fraction (EF 40%). He was initiated on treatment for myopericarditis with colchicine and high-dose ASA (650 mg three times daily) for 3\u20134 weeks, with significant symptom improvement within 1\u20132 days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Emergency physicians should initiate early treatment for myopericarditis to reduce inflammation for improved patient outcomes while still considering ACS in all patients presenting with chest pain. Point-of-care ultrasound can identify a pericardial effusion or acute heart failure to guide management. Patients with myocardial involvement can develop permanent heart damage but can exhibit excellent recovery with appropriate treatment, which includes nonsteroidal anti-inflammatories, colchicine, and high-dose ASA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s43044-026-00734-7","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T07:28:58Z","timestamp":1775546938000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Myopericarditis in an emergency department patient presenting with chest pain and ECG changes: a case report"],"prefix":"10.1186","volume":"78","author":[{"given":"Lauren","family":"Coaxum","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colleen","family":"McClean","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Theophanous","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"issue":"7\u201314","key":"734_CR1","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1016\/j.jacc.2019.11.021","volume":"75","author":"JG Chiabrando","year":"2020","unstructured":"Chiabrando JG, Bonaventura A, Vecchie A et al (2020) Management of Acute and Recurrent Pericarditis: JACC State-of-the-Art Review. J Am Coll Cardiol Jan 75(7\u201314):76\u201392","journal-title":"J Am Coll Cardiol Jan"},{"issue":"13","key":"734_CR2","doi-asserted-by":"publisher","first-page":"1098","DOI":"10.1001\/jama.2023.3371","volume":"329","author":"E Ammirati","year":"2023","unstructured":"Ammirati E, Moslehi JJ (2023) Diagnosis and Treatment of Acute Myocarditis: A Review. JAMA 329(13):1098\u20131113","journal-title":"JAMA"},{"key":"734_CR3","first-page":"135","volume":"3","author":"S Sheth","year":"2010","unstructured":"Sheth S, Wang DD, Kasapis C (2010) Current and emerging strategies for the treatment of acute pericarditis: a systematic review. J Inflamm Res 3:135\u2013142","journal-title":"J Inflamm Res"},{"key":"734_CR4","doi-asserted-by":"publisher","unstructured":"Schulz-Menger J, Collini V, Groschel J et al (2025) 2025 ESC Guidelines for the management of myocarditis and pericarditis: Developed by the task force for the management of myocarditis and pericarditis of the European Society of Cardiology (ESC). European Heart Journal. 21 Oct 46(40):3952\u20134041. https:\/\/doi.org\/10.1093\/eurheartj\/ehaf192","DOI":"10.1093\/eurheartj\/ehaf192"},{"key":"734_CR5","doi-asserted-by":"publisher","unstructured":"Martens P, Cooper LT, Tan WH (2023) Diagnostic Approach for Suspected Acute Myocarditis: Considerations for Standardization and Broadening Clinical Spectrum. J Am Heart Assoc. 17 Aug 12(17). https:\/\/doi.org\/10.1161\/JAHA.123.031454","DOI":"10.1161\/JAHA.123.031454"},{"issue":"4","key":"734_CR6","doi-asserted-by":"publisher","first-page":"562","DOI":"10.1016\/j.jemermed.2020.01.017","volume":"58","author":"MD Witting","year":"2020","unstructured":"Witting MD, Hu KM, Westreich AA et al (2020) Evaluation of Spodick\u2019s Sign and Other Electrocardiographic Findings as Indicators of STEMI and Pericarditis. J Emerg Med 58(4):562\u2013569","journal-title":"J Emerg Med"},{"issue":"7","key":"734_CR7","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1016\/S2213-2600(22)00059-5","volume":"10","author":"RR Ling","year":"2022","unstructured":"Ling RR, Ramanathan K, Tan FL et al (2022) Myopericarditis following COVID-19 vaccination and non COVID-19 vaccination: a systematic review and meta-analysis. Lancet Respir Med 10(7):679\u2013688","journal-title":"Lancet Respir Med"},{"issue":"2","key":"734_CR8","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1586\/erc.12.184","volume":"11","author":"M Imazio","year":"2013","unstructured":"Imazio M, Cooper LT (2013) Management of myopericarditis. Expert Rev Cardiovasc Ther 11(2):193\u2013201","journal-title":"Expert Rev Cardiovasc Ther"},{"key":"734_CR9","doi-asserted-by":"publisher","first-page":"1326","DOI":"10.1093\/eurheartj\/ehm076","volume":"28","author":"AL Caforio","year":"2007","unstructured":"Caforio AL, Calabrese F, Angelini A et al (2007) A prospective study of biopsy-proven myocarditis: prognostic relevance of clinical and aetiopathogenetic features at diagnosis. Eur Heart J 28:1326\u20131333","journal-title":"Eur Heart J"},{"key":"734_CR10","doi-asserted-by":"publisher","first-page":"1088","DOI":"10.1161\/CIRCULATIONAHA.118.035319","volume":"138","author":"E Ammirati","year":"2018","unstructured":"Ammirati E, Cipriani M, Moro C et al (2018) Clinical presentation and outcome in a contemporary cohort of patients with acute myocarditis: multicenter Lombardy registry. Circulation 138:1088\u20131099","journal-title":"Circulation"}],"container-title":["The Egyptian Heart Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s43044-026-00734-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s43044-026-00734-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s43044-026-00734-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T07:28:59Z","timestamp":1775546939000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s43044-026-00734-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,7]]},"references-count":10,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["734"],"URL":"https:\/\/doi.org\/10.1186\/s43044-026-00734-7","relation":{},"ISSN":["2090-911X"],"issn-type":[{"value":"2090-911X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,7]]},"assertion":[{"value":"16 October 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 April 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was performed according to the Declaration of Helsinski. Ethics approval and consent is waived per the DUHS case report policy (below), but consent was obtained from the patient in this case.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All the authors contributed to this work and have reviewed the final manuscript. All authors consent to publication of this work. No identifying patient information is present in this manuscript. The patient signed written institutional consent for publication of this case in a scientific journal and for presentation. Also, per the institution\u2019s case report policy 4\/4\/2021: \u201cFederal regulations (45CFR46.102 and 45CFR164.501) define research as a systematic investigation, including research development, testing and evaluation, designed to develop or contribute to generalizable knowledge. The review of medical records for publication of a single case report or a case series involving data from two or three patients is not considered by the institutional IRB to be research involving human subjects, and therefore such a report of medical cases does not require IRB review and approval. This is because reporting such a small series of patients does not involve a systematic investigation, including defining a hypothesis that is then investigated prospectively and systematically, to develop or contribute to generalizable knowledge. Thereby consent for participation and publication is waived.\u201d","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"22"}}