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Small Bowel Perforated Viscus Mimicking Inferior Wall Myocardial Infarction: A Case Report

Jesus Romero1, Yezin Shamoon2, Melvin Santana2

  • 1RWJBarnabas Health/Trinitas Regional Medical Center, Elizabeth, NJ, USA.

Journal of Community Hospital Internal Medicine Perspectives
|October 11, 2024
PubMed

Insights

Acute coronary syndrome (ACS) mimics can arise from non-cardiac issues. This case highlights how a perforated viscus caused EKG changes, mimicking ACS and stressing diagnostic vigilance.

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Medical Diagnostics

Background:

  • Acute coronary syndrome (ACS) involves cardiac ischemia, potentially causing myocardial injury or necrosis.
  • Electrocardiogram (EKG) is vital for diagnosing ACS, guiding vascular territory assessment and therapy.
  • Non-cardiac conditions can present with EKG changes that mimic ACS, risking misdiagnosis.

Observation:

  • A 57-year-old female with a history of coronary artery disease (CAD) presented unresponsive and pulseless.
  • The patient's condition was secondary to a perforated viscus.
  • Initial EKG revealed ST-segment elevations in the inferior leads.

Findings:

  • The patient's presentation mimicked ACS due to EKG abnormalities.
  • The underlying cause was identified as a perforated viscus, a non-cardiac emergency.
  • This case underscores the importance of considering non-cardiac etiologies for EKG changes.

Implications:

  • Accurate diagnosis is crucial to avoid inappropriate ACS management.
  • Clinicians must maintain a high index of suspicion for non-cardiac causes of ST-segment elevation.
  • Broadening the differential diagnosis in critical care settings improves patient outcomes.

Keywords:
Acute coronary syndromePerforated viscusPneumoperitoneum

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