Acute ST-segment elevation myocardial infarction: to be or not to be?

Area of Science:

• Cardiology
• Electrophysiology
• Internal Medicine

Background:

• Calcium ions are crucial for myocardial function, influencing action potentials, intracellular signaling, and muscle contraction.
• Abnormal calcium levels, particularly hypocalcemia, can manifest on electrocardiograms (ECGs) with arrhythmias or QT prolongation.

Observation:

• A 28-year-old male presented with chest pain, exhibiting ECG findings suggestive of ST-elevation myocardial infarction (STEMI).
• Initial diagnosis was STEMI, but further investigation revealed severe hypocalcemia as the underlying cause.

Findings:

• Hypocalcemia can present with ST segment variations, mimicking acute cardiac events like STEMI.
• This case underscores the diagnostic challenge posed by electrolyte disturbances mimicking primary cardiac pathology.

Implications:

• Clinicians must consider hypocalcemia in the differential diagnosis of patients presenting with chest pain and ECG changes suggestive of myocardial infarction.
• Prompt recognition and management of electrolyte imbalances are critical to avoid misdiagnosis and ensure appropriate patient care.