Fulminant myocarditis (FM) is a severe disease with a rapidly progressive and life-threatening course caused mainly by viral infection. The symptoms, laboratory findings, and presence of ECG changes resemble acute coronary syndrome. Therefore, coronary angiography is usually helpful in making the appropriate diagnosis. However, failure to obtain complete coronary artery images due to coronary artery anatomic variations poses a challenge for the diagnosis of FM. Here, we report a case of FM preliminarily diagnosed as acute coronary syndrome (ACS) due to the presence of coronary artery anomaly.

中文翻译：

---

冠状动脉造影失败时暴发性心肌炎与急性冠状动脉综合征的鉴别诊断：病例报告

暴发性心肌炎（FM）是一种严重的疾病，主要由病毒感染引起，进展迅速且危及生命。症状、实验室检查结果和心电图改变的存在类似于急性冠状动脉综合征。因此，冠状动脉造影通常有助于做出适当的诊断。然而，由于冠状动脉解剖变异而无法获得完整的冠状动脉图像，这对 FM 的诊断提出了挑战。在这里，我们报告一例因冠状动脉异常而初步诊断为急性冠状动脉综合征 (ACS) 的 FM。