Dramatic electrocardiographic T-wave changes associated with gastric dilatation

A case report is presented of a 54-year old female patient with a history of acute-onset sharp retrosternal chest pain. Clinical examination was unremarkable, but the 12-lead ECG showed anterior T-wave inversion and the chest x-ray film showed gaseous dilatation of the stomach. The patient's symptoms and electrocardiographic abnormalities resolved immediately after gastric decompression. Further investigations revealed no evidence of coronary artery disease. This case report documents marked T-wave changes and atypical chest pain with gastric dilatation. The possible causes of the ECG changes and chest pain are discussed.