PMC3103881_01
Laboratory results of cardiac biomarkers during hospitalization in a patient with Salmonella enteritidis associated acute myocarditis.
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C-reactive protein (11.28 mg/dL with upper limit normal (ULN) 10). Creatine phosphokinase (CK): 107 U/L (ULN: 171), aspartate aminotransferase (AST): 19 IU/L (ULN: 35), and lactate dehydrogenase (LDH): 155 IU/L (ULN: 247) were normal (Figure 1). IU/L and 197 IU/L, resp.) (Figure 1). A new ECG did not reveal changes compared to the previous ones, while an echocardiogram (ECHO) was also performed. It was normal without hypokinetic areas. TnI test was positive (qualitative assay) at that time, and assessment with a quantitative assay showed remarkable elevation of TnI (23 ng/mL; ULN: 0.4) (Figure 1).  Tnl became normal on the fourth date and LDH on the sixth day (Figure 1). The ECG evolved with T wave inversion in lead III and biphasic T wave in leads V4 and V5 on the third day (Figure 2(b)).
(a) ECG on admission, with changes due to early repolarization. (b) ECG on the third day, with T wave inversion in lead III and biphasic T wave in leads V4 and V5.
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fig2
The electrocardiogram (ECG) performed in the ED was also normal, exhibiting upslope displacement of ST segment in precordial leads due to early repolarization (changes without clinical significance in young adults) (Figure 2(a)). Tnl became normal on the fourth date and LDH on the sixth day (Figure 1). The ECG evolved with T wave inversion in lead III and biphasic T wave in leads V4 and V5 on the third day (Figure 2(b)).