Reversible Inferolateral ST-Segment Elevation Associated with Small Bowel Obstruction

Area of Science:

• Cardiology
• Gastroenterology
• Internal Medicine

Background:

• ST-segment elevation on electrocardiograms (ECGs) typically indicates acute myocardial infarction but can arise from non-cardiac conditions.
• Gastrointestinal pathologies, particularly small bowel obstruction, can present with symptoms that mimic cardiac events, complicating diagnosis.

Observation:

• Two patients with a history of abdominal surgeries presented with epigastric pain and ECGs showing ST-segment elevation in inferior and lateral leads.
• No evidence of coronary artery disease was found in either patient, suggesting an alternative etiology for the ECG findings.

Findings:

• The ST-segment elevation in both patients was attributed to the intra-abdominal pathology of small bowel obstruction.
• Surgical treatment for small bowel obstruction resulted in the prompt resolution of the observed ST-segment elevation on ECGs.

Implications:

• This case series underscores the critical importance of considering non-cardiac causes, such as small bowel obstruction, in patients presenting with ST-segment elevation.
• Failure to recognize the gastrointestinal origin can lead to diagnostic delays, unnecessary invasive procedures, and potential complications.
• Further research is warranted to elucidate the pathophysiological mechanisms linking small bowel obstruction to electrocardiographic changes.