Sudden Cardiac Arrest in a Previously Healthy Young Male: Perimyocarditis Presenting as Myocardial Infarction With Non-obstructive Coronary Arteries.
5 affiliations
- 1Department of Cardiology, General Hospital of Culiacán, Autonomous University of Sinaloa, Culiacán, MEX.
- 2Department of Clinical and Interventional Cardiology, Center for Research and Teaching in Health Sciences, Autonomous University of Sinaloa, Civil Hospital of Culiacán, Culiacán, MEX.
- 3Department of Clinical and Interventional Cardiology, Hospital Angeles Culiacán, Culiacán, MEX.
- 4Department of Internal Medicine, Center for Research and Teaching in Health Sciences, Autonomous University of Sinaloa, Civil Hospital of Culiacán, Culiacán, MEX.
- 5Department of Internal Medicine, General Hospital of Culiacán, Autonomous University of Sinaloa, Culiacán, MEX.
Abstract
Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a heterogeneous clinical entity that may mimic acute coronary syndromes despite the absence of significant epicardial coronary artery disease. Inflammatory myocardial conditions, such as myocarditis and perimyocarditis, represent important non-ischemic causes of MINOCA and may present with life-threatening complications, including malignant ventricular arrhythmias and sudden cardiac arrest. We report a case of a 37-year-old previously healthy male who presented with chest discomfort, syncope, and sudden cardiac arrest due to ventricular fibrillation. Post-cardiac arrest electrocardiography revealed extensive anterior ST-segment elevation, with markedly elevated cardiac biomarkers and transient severe left ventricular systolic dysfunction. Coronary angiography demonstrated non-obstructive epicardial coronary arteries, leading to the diagnosis of MINOCA. Cardiac magnetic resonance imaging revealed late gadolinium enhancement in a pattern consistent with perimyocarditis. The patient required advanced life support and intensive care management for cardiogenic shock, followed by progressive clinical improvement with complete recovery of left ventricular function. This case highlights perimyocarditis as a rare but critical cause of MINOCA presenting with sudden cardiac arrest and malignant ventricular arrhythmias in a young patient. It underscores the importance of a systematic diagnostic approach and emphasizes cardiac magnetic resonance as a key tool for etiological diagnosis, guiding appropriate management and enabling full functional recovery.
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BibTeX
@article{sanchez2026sudden,
title = {{Sudden Cardiac Arrest in a Previously Healthy Young Male: Perimyocarditis Presenting as Myocardial Infarction With Non-obstructive Coronary Arteries.}},
author = {Marco Antonio Rodríguez Sánchez and Victor Emmanuel Gonzalez Zazueta and Luis David Beltrán Ontiveros and Jesus Miguel Figueroa Zaldivar and Ellanyn Beltrán López and José Manuel Aguilar Rubio and Estefany Adelina Angulo Lapizco},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.116593},
url = {https://europepmc.org/article/MED/42904250},
note = {CC BY},
}
RIS
TY - JOUR
TI - Sudden Cardiac Arrest in a Previously Healthy Young Male: Perimyocarditis Presenting as Myocardial Infarction With Non-obstructive Coronary Arteries.
AU - Marco Antonio Rodríguez Sánchez
AU - Victor Emmanuel Gonzalez Zazueta
AU - Luis David Beltrán Ontiveros
AU - Jesus Miguel Figueroa Zaldivar
AU - Ellanyn Beltrán López
AU - José Manuel Aguilar Rubio
AU - Estefany Adelina Angulo Lapizco
PY - 2026
DA - 2026/09/20
JO - Cureus
DO - 10.7759/cureus.116593
UR - https://europepmc.org/article/MED/42904250
AB - Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a heterogeneous clinical entity that may mimic acute coronary syndromes despite the absence of significant epicardial coronary artery disease. Inflammatory myocardial conditions, such as myocarditis and perimyocarditis, represent important non-ischemic causes of MINOCA and may present with life-threatening complications, including malignant ventricular arrhythmias and sudden cardiac arrest. We report a case of a 37-year-old previously healthy male who presented with chest discomfort, syncope, and sudden cardiac arrest due to ventricular fibrillation. Post-cardiac arrest electrocardiography revealed extensive anterior ST-segment elevation, with markedly elevated cardiac biomarkers and transient severe left ventricular systolic dysfunction. Coronary angiography demonstrated non-obstructive epicardial coronary arteries, leading to the diagnosis of MINOCA. Cardiac magnetic resonance imaging revealed late gadolinium enhancement in a pattern consistent with perimyocarditis. The patient required advanced life support and intensive care management for cardiogenic shock, followed by progressive clinical improvement with complete recovery of left ventricular function. This case highlights perimyocarditis as a rare but critical cause of MINOCA presenting with sudden cardiac arrest and malignant ventricular arrhythmias in a young patient. It underscores the importance of a systematic diagnostic approach and emphasizes cardiac magnetic resonance as a key tool for etiological diagnosis, guiding appropriate management and enabling full functional recovery.
SN - 2168-8184
ER -