Mimicking descending necrotizing mediastinitis as acute myocardial infarction in a patient with severe coronary artery disease: A case report

Abstract

Rationale: It is a crucial disease that descending necrotizing mediastinitis need to be treated promptly with proper antibiotics and drainage. The characteristics of its symptoms such as chest pain are difficult to distinguish from acute myocardial infarction. Patient concerns: An 80-year-old female presented with severe squeezing chest pain. The cardiac marker was elevated. And coronary angiography showed the significant coronary stenosis. Although the revascularization through percutaneous coronary intervention was completed successfully, the patient still presented chest pain. Computed tomography of neck revealed that hypodense heterogeneous lesions with clear and distinguishable margin extended from the deep neck to mediastinum diffusely. Diagnoses: The patient was diagnosed with descending necrotizing mediastinitis. Interventions: Percutaneous catheter insertion to patient’s abscess lesion at was performed. Outcomes: Catheter drainage of descending necrotizing mediastinitis led to an improvement in the patient’s condition. Lesson: Descending necrotizing mediastinitis made chest paint with elevated cardiac enzyme mimicked myocardial infarction.