• Yu Jung Jung and Jong-Il Park.
• Division of Cardiology, Yeungnam University Medical Center, Daegu, Republic of Korea.
• Medicine (Baltimore). 2023 Dec 8; 102 (49): e36571e36571.

RationaleIt 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 ConcernsAn 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.DiagnosesThe patient was diagnosed with descending necrotizing mediastinitis.InterventionsPercutaneous catheter insertion to patient's abscess lesion at was performed.OutcomesCatheter drainage of descending necrotizing mediastinitis led to an improvement in the patient's condition.LessonDescending necrotizing mediastinitis made chest paint with elevated cardiac enzyme mimicked myocardial infarction.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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