Acute pancreatitis presenting as acute inferior wall ST-segment elevations on electrocardiography
Amgad N Makaryus1, Oluwatoyin Adedeji, Sayed K Ali
1Division of Cardiology, Department of Medicine, North Shore University Hospital, Manhasset, NY 11030, USA. amakaryu@nshs.edu
The American Journal of Emergency Medicine
|July 9, 2008
Summary
Acute pancreatitis can cause electrocardiogram (ECG) changes mimicking myocardial infarction, leading to unnecessary invasive procedures. Early recognition of pancreatitis is crucial for accurate diagnosis and appropriate patient management.
Area of Science:
- Cardiology
- Gastroenterology
- Emergency Medicine
Background:
- Electrocardiograms (ECG) are vital for diagnosing acute coronary syndromes.
- Chest pain is a common emergency department presentation.
- Acute pancreatitis can present with symptoms overlapping cardiac ischemia.
Observation:
- A patient with coronary artery disease risk factors presented with chest pressure and ECG changes indicative of myocardial infarction.
- Coronary angiography revealed normal coronary arteries.
- The patient was diagnosed with acute pancreatitis via elevated pancreatic enzymes and CT scan.
Findings:
- ECG abnormalities in acute pancreatitis can mimic acute myocardial infarction.
- This mimicry can lead to misdiagnosis and inappropriate invasive cardiac interventions.
- Pancreatitis should be considered in the differential diagnosis of chest pain with ECG changes, especially with epigastric pain.
Implications:
- Recognizing ECG changes associated with pancreatitis can prevent unnecessary cardiac procedures.
- This case highlights the importance of a comprehensive differential diagnosis in patients with chest pain.
- Improved diagnostic strategies are needed to differentiate pancreatitis from cardiac events.
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