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Gastrointestinal Distention Masquerading as ST-Segment Elevation Myocardial Infarction

James Zhang1, Hussain Basrawala1, Sumit Patel1

  • 1Division of Cardiovascular Medicine, University of Southern California, Los Angeles, California.

JACC. Case Reports
|July 28, 2021
PubMed

Insights

Gastrointestinal issues like distention and ileus can mimic ST-segment elevation myocardial infarction (STEMI) on electrocardiograms. This case study explores the mechanism behind this electrocardiographic mimicry, aiding in accurate diagnosis.

Area of Science:

  • Cardiology
  • Gastroenterology
  • Diagnostic Imaging

Background:

  • ST-segment elevation myocardial infarction (STEMI) is a critical manifestation of acute coronary syndrome, characterized by significant electrocardiogram (ECG) changes.
  • Accurate and timely diagnosis of STEMI is crucial for initiating life-saving interventions.
  • Noncardiac conditions can present with ECG findings that mimic STEMI, posing diagnostic challenges.

Observation:

  • This report details a specific case where severe gastrointestinal distention and ileus presented as ST-segment elevation on an ECG.
  • The patient's clinical presentation initially suggested an acute cardiac event.

Findings:

  • The study posits a potential mechanism by which gastrointestinal distention and ileus can lead to ECG changes resembling STEMI.
  • This highlights the importance of considering noncardiac etiologies in the differential diagnosis of STEMI.

Implications:

  • Understanding these noncardiac mimics can prevent unnecessary and potentially harmful cardiac interventions.
  • This knowledge can improve diagnostic accuracy and patient outcomes in emergency settings.
  • Further research into the electrophysiological links between gastrointestinal and cardiac systems is warranted.

Keywords:
ACS, acute coronary syndromeECG, electrocardiographyICU, intensive care unitSTEMISTEMI, ST-segment elevation myocardial infarctionelectrocardiographygastric distention

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