[The clinical significance of postictal electrocardiographic changes mimicking acute myocardial infarction]

Area of Science:

• Cardiology
• Neurology

Background:

• The electrocardiogram (ECG) is vital for diagnosing acute myocardial infarction.
• Certain non-cardiac conditions can present with ECG abnormalities, including ST elevation and T wave inversion, mimicking cardiac events.

Observation:

• This report details a case following epileptic seizures with a pathological electroencephalogram (EEG).
• The patient's ECG exhibited repolarization abnormalities suggestive of acute myocardial infarction.
• Cardiac enzymes were elevated, but coronary angiography revealed no cardiac abnormalities.

Findings:

• Epileptic seizures can trigger ECG changes that mimic acute myocardial infarction.
• Elevated cardiac enzymes, in the absence of coronary artery disease, can be associated with non-cardiac events.

Implications:

• Increased awareness of non-cardiac syndromes presenting with ECG changes is essential.
• This understanding can help clinicians avoid inappropriate and potentially harmful thrombolytic therapy for non-cardiac conditions.
• Distinguishing true myocardial infarction from ECG mimics is critical for patient management.