Abdominal pain and ECG alteration: a simple diagnosis?

Acute pancreatitis is a disease initially located into the pancreas that may become a systemic disease involving organs distant from the pancreas. All organs may be involved during an acute attack of pancreatitis: lungs, kidney, heart, liver, brain. The differential is sometime difficult because acute pancreatitis may sometimes mimic an acute coronary syndrome. We report a case of a 36-year-old man who was admitted to Emergency Room for persistent epigastric pain. Serial electrocardiograms (ECG) showed signs of acute myocardial infarction. However, a coronary angiogram demonstrated no coronary artery disease, and serum troponin was undetectable. Later, serum pancreatic enzyme levels were elevated and an ultrasonography scan of the abdomen was consistent with pancreatitis. Physicians should keep in mind the possibility of an attack of pancreatitis in a patient with abdominal pain and ECG modifications who is a heavy drinker.