Ileus causing STEMI electrocardiographic findings

This case report details an ST-segment elevation due to ileus and gastric dilation. The ECG recorded in a man in his 70s with nausea, vomiting and epigastric discomfort showed ST-segment elevation in the inferolateral leads. No coronary artery stenoses were found. However, a CT scan displayed gastric and jejunal loop dilation and the ECG returned to normal after gastric decompression. Although several mechanisms might be implicated, our findings are likely related to cardiac external compression and injury on a limited myocardial region. This article underscores that gastric compression on the heart is a non-cardiac cause of ST-segment elevation and mild myocardial damage. Therefore, in case of a suggestive clinical presentation, physicians must investigate gastric dilation after ruling out myocardial infarction.