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Typical pericarditis ECG findings after falling from height. The PR segment depression or ST segment elevation?
Murat Sucu1, Gokhan Altunbas1, Fatma Yilmaz Coskun1
1Gaziantep University, Department of Cardiology, Gaziantep, Turkey.
Turkish Journal of Emergency Medicine
|February 22, 2018
Summary
Acute pericarditis after blunt chest trauma is rare and challenging to diagnose. This case highlights how it can mimic a heart attack (STEMI) on ECG, despite normal cardiac enzymes.
Area of Science:
- Cardiology
- Trauma Medicine
- Emergency Medicine
Background:
- Acute pericarditis following blunt thoracic trauma is an uncommon clinical presentation.
- Diagnosis can be challenging due to its rarity and overlapping symptoms with other cardiac emergencies.
Observation:
- A 43-year-old male presented after a fall, exhibiting ECG abnormalities including PR segment depression.
- Initial ECG findings suggested acute ST-elevation myocardial infarction (STEMI).
- The patient also showed signs of systemic inflammation, such as leukocytosis and elevated erythrocyte sedimentation rate.
Findings:
- The patient was diagnosed with acute pericarditis, not STEMI.
- ECG changes, specifically PR segment depression, mimicked myocardial infarction.
- Cardiac enzymes remained normal, differentiating it from acute myocardial infarction.
Implications:
- This case underscores the importance of considering acute pericarditis in patients with chest trauma and ECG changes.
- PR segment depression in the context of trauma can be a sign of pericarditis, necessitating careful evaluation.
- Distinguishing post-traumatic pericarditis from STEMI is crucial for appropriate management and patient outcomes.
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