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Rupturing Abdominal Aneurysm Presenting as Acute Coronary Syndrome
Willeke Van der Stuijt1, Remko S Kuipers2
1Cardiology, Amsterdam University Medical Centers, Amsterdam, NLD.
Cureus
|August 25, 2020
Summary
Abnormal ECGs and elevated cardiac enzymes can mimic acute coronary syndrome (ACS). This case highlights the critical need to rule out other life-threatening conditions, such as ruptured aortic aneurysms, before treating for ACS.
Area of Science:
- Cardiology
- Vascular Surgery
- Emergency Medicine
Background:
- Acute coronary syndrome (ACS) diagnosis relies on ECG and cardiac enzyme evaluation.
- Abdominal pathologies can present with symptoms mimicking cardiac events.
- Prompt diagnosis and treatment are crucial for life-threatening conditions.
Observation:
- A 61-year-old male presented with upper abdominal pain, ECG abnormalities, and elevated cardiac enzymes.
- Initial assessment focused on excluding cardiac pathology (ACS).
- Clinical deterioration led to emergency laparotomy, revealing a ruptured aortic aneurysm.
Findings:
- Ruptured aortic aneurysm was the underlying cause of the patient's presentation.
- Despite revascularization, the patient experienced multiple organ failure and died.
- The case underscores the potential for non-cardiac conditions to present as ACS.
Implications:
- Clinicians must maintain a high index of suspicion for other critical diagnoses in patients presenting with ACS symptoms.
- Delaying investigation of potential abdominal pathologies can have fatal consequences.
- Integrated diagnostic approaches are essential to differentiate cardiac from non-cardiac emergencies presenting with similar signs.
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