Differential diagnosis of the association of gastrointestinal symptoms and ST segment elevation, in the absence of chest pain

Jolobe, Oscar M.P.

doi:10.1016/j.ajem.2021.05.067

Cited by 6 publications

(6 citation statements)

References 32 publications

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“…ST segment elevation has been reported in patients with acute cholecystitis, acute pancreatitis, perforated gastric ulcer and oesophageal rupture without evidence of acute myocardial infarction or inflammation 7 8. Thus, the current study shows that there is myocardial involvement in some of the patients with ST segment elevation.…”

supporting

confidence: 57%

How electrically silent is the pericardium?

Birnbaum

Uretsky

2022

Heart

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supporting

confidence: 57%

How electrically silent is the pericardium?

Birnbaum

Uretsky

2022

Heart

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“…Those associated with cardiac diseases include STEMI, 2,3,6 acute myocarditis, 7 acute pericarditis, 8,9 ERS, 10 LBBB, 1,3,6,11 apical ballooning syndrome (ABS), 1,12 and Brugada syndrome 3,11,13 . Additionally, ST‐segment elevation can also be observed in other extracardiac diseases, such as hyperkalaemia, 3,11 pulmonary embolism, 10,14 and acute abdomen 15 . Notably, these diseases can be differentiated and diagnosed by the abnormal characteristics of ECG, including the type of ST‐segment elevation, T wave, QRS wave, characteristic symptoms and signs, and corresponding auxiliary examinations.…”

Section: Discussionmentioning

confidence: 99%

Persistent convex ST‐segment elevation in a patient with a history of prior intracerebral haemorrhage

Jiang,

Jin,

et al. 2024

ESC Heart Failure

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Management of patients with acute chest pain poses a significant challenge in identifying those requiring urgent coronary reperfusion. Electrocardiogram (ECG) constitutes the cornerstone in making prompt clinical decisions by identifying ST‐segment elevation, commonly associated with ST‐segment elevation myocardial infarction. It is important to note that ST‐segment elevation can also be a manifestation of various cardiac and non‐cardiac conditions, from acute myocarditis, early repolarization syndrome, acute pericarditis, and left bundle branch block to unknown origins. The similarity of ECG changes among these conditions complicates clinical differential diagnosis, necessitating a detailed medical history and thorough examinations. Here, we presented a case of a 52‐year‐old female with chest pain and unidentified convex ST‐segment elevation. Considering the negative emergent coronary angiography results, normal echocardiography, and long‐lasting ST‐segment elevation for the following 1 year, the final diagnosis was non‐myocardial infarction, probably related to a prior cerebral haemorrhage.

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“…The possible causes of gastrointestinal symptoms include perforated gastric ulcer, intestinal obstruction, acute appendicitis, acute pancreatitis, and acute cholecystitis. Furthermore, these can also coexist with AMI ( 14 ). To mitigate the misdiagnosis of STEMI, echocardiography and CCTA should be undertaken to identify the causes of myocardial ischemia, especially in conditions of concomitant acute abdomen.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Abnormal ECG in a Patient With Acute Pancreatitis

Long

Tang

Wang

et al. 2021

Front. Cardiovasc. Med.

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Background: Both acute pancreatitis and acute myocardial infarction (AMI) are rapidly progressive and frequently fatal diseases that can be interrelated and lead to a vicious cycle for further problems. The concomitant occurrence of AMI and acute pancreatitis is rare but critical, and efficient diagnosis and treatment of such patients are challenging.Case Summary: We reported an uncommon case of abnormal ECG findings in a 63-year-old woman with acute pancreatitis. The patient exhibited increased biomarkers of myocardial injury, such as creatine kinase-MB (CK-MB) and troponin T, as well as ST segment elevation in inferior leads II, III, and aVF. Both of these have been previously observed in patients with acute abdomen in the absence of ST-segment elevation myocardial infarction (STEMI), including pancreatitis. In addition, lacking complaints of chest pain or tightness was also supportive of this idea. Echocardiography indicated abnormalities in the functioning of the left inferior posterior wall segments and decreased overall systolic function of the left ventricle with a 51% ejection fraction. Eventually, AMI was diagnosed after coronary computed tomography angiography (CCTA) showing critical stenosis of the right coronary artery and left anterior descending artery segments. The patient was urgently transferred to intensive care unit and was treated with anticoagulation, antiplatelet aggregation, lipid-lowering and other palliative drugs.Conclusion: Concomitant acute pancreatitis and AMI are often considered to be critical conditions with a poor prognosis. Therefore, it is important to rapidly identify this condition and consider transferring patients for multidisciplinary supportive care.

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Differential diagnosis of the association of gastrointestinal symptoms and ST segment elevation, in the absence of chest pain

Cited by 6 publications

References 32 publications

How electrically silent is the pericardium?

How electrically silent is the pericardium?

Persistent convex ST‐segment elevation in a patient with a history of prior intracerebral haemorrhage

Case Report: Abnormal ECG in a Patient With Acute Pancreatitis

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