Abstract：
Electrocardiographic (ECG) findings of T-wave inversions in V1-V3, with or without accompanying epsilon waves, often raise concerns for the rare, but potentially lethal, arrhythmogenic right ventricular cardiomyopathy (ARVC). However, this pattern may be found in pericardial agenesis, an even rarer pathology. Concomitant myocarditis can confuse this presentation further.
We report a case of a previously healthy man who presented with left-sided chest pain, ECG findings suggestive of ARVC, and a final diagnosis of myocarditis with underlying partial pericardial agenesis. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: A growing number of cases have reported pericardial agenesis demonstrating ECG changes similar to ARVC. We discuss an approach to a diagnostically challenging patient. This case emphasizes the importance of a broad differential and the danger of premature closure.
We report a case of a previously healthy man who presented with left-sided chest pain, ECG findings suggestive of ARVC, and a final diagnosis of myocarditis with underlying partial pericardial agenesis. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: A growing number of cases have reported pericardial agenesis demonstrating ECG changes similar to ARVC. We discuss an approach to a diagnostically challenging patient. This case emphasizes the importance of a broad differential and the danger of premature closure.
摘要：
背景：V1-V3中T波倒置的心电图（ECG）发现，有或没有伴随的ε波，经常引起人们对稀有事物的关注，但可能是致命的,致心律失常性右心室心肌病（ARVC）。然而,这种模式可能在心包发育不全中发现，更罕见的病理学。合并心肌炎可以进一步混淆这种表现。
方法：我们报告一例以前健康的男性，他出现左侧胸痛，心电图结果提示ARVC,最终诊断为心肌炎并伴有部分心包发育不全。为什么急诊医生应该意识到这一点？：越来越多的病例报告心包发育不全，其心电图改变类似于ARVC。我们讨论了一种诊断挑战性患者的方法。这个案例强调了广泛差异的重要性和过早关闭的危险。
方法：我们报告一例以前健康的男性，他出现左侧胸痛，心电图结果提示ARVC,最终诊断为心肌炎并伴有部分心包发育不全。为什么急诊医生应该意识到这一点？：越来越多的病例报告心包发育不全，其心电图改变类似于ARVC。我们讨论了一种诊断挑战性患者的方法。这个案例强调了广泛差异的重要性和过早关闭的危险。
