36yo male, nonsmoker. Obese (BMI 36), hypertensive, high cholesterol, prediabetic. I went to the emergency room for flu-like symptoms, heart palpitations, and fatigue. My heart rate was 118 at rest with PVCs, and my troponin was 245. Neither number decreased throughout my visit. I was diagnosed with pericarditis and sent home. At my PCP follow-up, it was mentioned off-handedly that my heart is enlarged and my ejection fraction is 45%. I was again sent home with no treatment or further follow-up.
Since then, I get short of breath and my heart races to 160+ BPM with any significant activity. I tire easily. The palpitations continue. I've heard pericarditis and STEMI can look similar on EKG--is it possible I had an MI and was misdiagnosed?
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It's important to understand that pericarditis and myocardial infarction (MI) can sometimes have similar symptoms and EKG findings. However, pericarditis typically presents with chest pain that worsens with deep breathing and a friction rub on physical examination, while MI often presents with more severe chest pain and changes in the ST segment on EKG.
Your elevated troponin level indicates that there was some damage to your heart muscle, which can be caused by pericarditis as well as MI. It's possible that you had an MI and were misdiagnosed with pericarditis, especially given your symptoms of shortness of breath, heart racing, and easy fatigue.
It's concerning that your PCP mentioned that your heart is enlarged and your ejection fraction is reduced to 45%. These findings suggest that there may be underlying heart disease that needs to be investigated and managed.
I would recommend seeking a second opinion from a cardiologist to further evaluate your symptoms and to assess your heart function. It's possible that you may need additional testing such as an echocardiogram, stress test, or cardiac catheterization to determine the cause of your symptoms and to guide appropriate treatment.
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