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Intestinal obstruction mimicking acute myocardial infarction
Timothy A Mixon1, Philip D Houck
1Division of Cardiology, Scott & White Clinic and Hospital, Scott, Sherwood and Brindley Foundation, Texas A&M University Health Science Center, College of Medicine, Temple, Texas 76508, USA. tmixon@swmail.sw.org
Texas Heart Institute Journal
|June 18, 2003
Summary
A jejunal conduit used in esophageal reconstruction can cause abdominal pain and heart attack symptoms by compressing the right ventricle. Nasogastric suction relieved these symptoms, identifying the conduit as the cause.
Area of Science:
- Cardiology
- Gastroenterology
- Thoracic Surgery
Background:
- Esophageal reconstruction frequently utilizes jejunal conduits, sometimes placed in the anterior mediastinum.
- Abdominal pain and electrocardiogram changes can mimic acute myocardial infarction.
Observation:
- A 64-year-old woman presented with abdominal pain and electrocardiogram findings suggestive of acute anteroseptal myocardial infarction.
- Her history included prior esophageal reconstruction with an anterior mediastinal jejunal conduit.
Findings:
- Echocardiography revealed a distended jejunal conduit compressing the right ventricle.
- This compression was identified as the cause of the patient's symptoms and electrocardiographic changes.
Implications:
- This case highlights a rare but significant complication of esophageal reconstruction with jejunal conduits.
- Prompt identification and management, such as nasogastric suction, can effectively resolve these symptoms.
- Awareness of this potential complication is crucial for clinicians managing patients with similar surgical histories.