Acute ST-segment elevation myocardial infarction: to be or not to be?
Maria Carolina Manzur Barbur1, Maria Cristina Martínez-Ávila1, Angélica Imitola Madero2
1Department of Internal Medicine, Centro Hospitalario Serena del Mar, Cartagena, Colombia.
Archive of Clinical Cases
|May 9, 2022
Summary
Severe hypocalcemia can mimic ST-elevation myocardial infarction (STEMI) on ECG, leading to misdiagnosis. This case highlights the importance of considering electrolyte imbalances in chest pain evaluations.
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.
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