Acute ST segment elevation secondary to acute gastric distention

Area of Science:

• Cardiology
• Gastroenterology
• Critical Care Medicine

Background:

• ST segment elevation on electrocardiogram (ECG) typically indicates acute myocardial infarction.
• Prompt diagnosis and treatment of myocardial infarction are crucial for patient outcomes.
• Alternative causes of ST segment elevation must be considered, especially in atypical presentations.

Purpose of the Study:

• To report a case of ST segment elevation mimicking myocardial infarction due to acute gastric distention.
• To emphasize the importance of considering gastric distention in the differential diagnosis of ST segment elevation in trauma patients.

Main Methods:

• A case report of an adolescent male trauma patient.
• ECG monitoring, laboratory tests (including troponins), and radiographic imaging were utilized.
• Intervention involved nasogastric tube placement for gastric decompression.

Main Results:

• The patient developed asymptomatic ST segment elevations on ECG after surgery.
• Laboratory tests, including troponins, were negative for myocardial infarction.
• Radiography revealed significant gaseous gastric distention.
• Following nasogastric decompression, the ST segment elevations resolved.

Conclusions:

• Acute gastric distention can present with ECG findings that mimic myocardial infarction.
• In asymptomatic patients with normal cardiac biomarkers, gastric distention should be considered as a potential cause of ST segment elevation.
• This case underscores the need for a broad differential diagnosis in trauma patients with unexpected ECG changes.