"Ischemic" ST elevation in a woman with left ventricular hypertrophy
Natale Daniele Brunetti1, Michele Correale, Rafel Sai
1Cardiology Department, University of Foggia, viale Pinto 1, 71100, Foggia, Italy. nd.brunetti@unifg.it
Journal of Thrombosis and Thrombolysis
|August 21, 2012
Insights
This case report highlights that ST elevation and chest pain can mimic heart attacks. These ECG changes were actually caused by asymmetric left ventricular hypertrophy and aortic stenosis, not coronary artery disease.
Area of Science:
- Cardiology
- Clinical Case Reports
- Cardiovascular Imaging
Background:
- ST elevation myocardial infarction (STEMI) is a critical condition requiring rapid diagnosis and intervention.
- Differential diagnosis of chest pain and ST elevation is crucial to avoid unnecessary treatments.
- Left ventricular hypertrophy (LVH) and aortic stenosis (AS) can present with atypical cardiac symptoms.
Observation:
- A female patient presented with symptoms suggestive of acute myocardial infarction, including ST elevation on electrocardiogram (ECG).
- Coronary angiography was performed to assess for coronary artery disease.
- The patient exhibited ECG anomalies not attributable to coronary blockages.
Findings:
- Coronary angiography revealed no significant coronary stenosis.
- The observed ECG abnormalities were correlated with underlying asymmetric left ventricular hypertrophy.
- Aortic stenosis was identified as a contributing factor to the patient's presentation.
Implications:
- This case underscores the importance of considering non-coronary causes for ST elevation and chest pain.
- Accurate diagnosis of conditions like LVH and AS is vital for appropriate patient management.
- Clinicians should maintain a broad differential diagnosis in patients presenting with acute cardiac symptoms.
Abstract:
We report the case of a woman who presented with ST elevation and episodes of chest pain, mimicking an acute myocardial infarction. At coronary angiography no sign of coronary stenosis was found and ECG anomalies were related to asymmetric left ventricular hypertrophy and aortic stenosis.
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