A case of fulminant hepatitis with electrocardiographic changes simulating acute myocardial infarction

Serial elctrocardiograms of a 55 year old female showed a trasiently elevated ST-T wave and decreased R waves in right precordial leads suggesting anterior wall infraction during the course of fulminant hepatitis. Autopsy findings revealed marked cerebral edema, massive necrosis of the liver with lymphocytic infiltration, partial myocardial degeneration and necrosis with infiltration by lymphocytes and plasma cells. However, no significant lesions were found in the coronary arterial trees. These findings suggest that the electrocardiographic changes were due to catecholamine cardiomyopathy or viral myocarditis.