Electrocardiographic changes and false-positive troponin I in a patient with acute cholecystitis

Area of Science:

• Cardiology
• Gastroenterology
• Medical Diagnostics

Background:

• Cardiac troponins are key biomarkers for myocardial injury, but can be elevated in non-cardiac conditions.
• Acute cholecystitis may present with electrocardiography (ECG) abnormalities, potentially confusing diagnosis with cardiac events.
• Overlapping symptoms of gallbladder and heart disease necessitate careful differential diagnosis.

Observation:

• A 75-year-old woman presented with symptoms suggestive of acute cholecystitis.
• She also exhibited transient ST segment elevation on ECG and elevated troponin I levels.
• Extensive cardiac workup ruled out myocardial ischemia or other acute cardiac pathology.

Findings:

• The elevated troponin I and ECG changes were exclusively attributed to acute cholecystitis.
• Gallbladder distension in cholecystitis was identified as the sole cause of the observed cardiac biomarkers and ECG abnormalities.
• This case demonstrates a non-cardiac cause for elevated troponin and pathological ECG findings.

Implications:

• Clinicians should consider acute cholecystitis in the differential diagnosis for patients presenting with elevated troponin and ECG changes.
• Prompt evaluation of the gallbladder is crucial in such cases to avoid misdiagnosis and ensure appropriate treatment.
• Understanding this association can improve diagnostic accuracy and patient management in emergency settings.