Respiratory acidosis induced ST-segment elevation
Yang Cheng1, Baotao Huang1, Mao Chen2
1Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu 610041, PR China.
The American Journal of Emergency Medicine
|May 25, 2023
Summary
Severe respiratory acidosis can mimic heart attacks, causing ST-segment elevation. Mechanical ventilation corrected both acidosis and electrocardiogram changes in a patient with rectal cancer.
Area of Science:
- Cardiology
- Oncology
- Critical Care Medicine
Background:
- Acidosis is a known potential cause of electrocardiogram (ECG) abnormalities.
- ST-segment elevation on ECG typically indicates myocardial infarction, necessitating urgent investigation.
Observation:
- A patient with rectal adenocarcinoma experienced cardiac arrest during contrast-enhanced computed tomography (CT).
- Following resuscitation, severe respiratory acidosis and anterior ST-segment elevation were detected on ECG.
- Coronary angiography and echocardiography showed no cardiac abnormalities, and CT revealed metastatic cancer but no cardiac involvement.
Findings:
- The ST-segment elevation resolved, and respiratory acidosis was corrected after initiating mechanical ventilation.
- This suggests a direct association between severe respiratory acidosis and the observed ECG changes.
Implications:
- This case highlights the importance of considering metabolic and respiratory derangements, such as acidosis, in the differential diagnosis of ST-segment elevation.
- Prompt recognition and management of underlying conditions like respiratory acidosis are crucial for appropriate patient care and avoiding unnecessary cardiac interventions.
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