Small Bowel Obstruction Mimicking Acute ST-Elevation Myocardial Infarction

Patel, Kunal; Chang, Nai–Lun; Shulik, Oleg; DePasquale, Joseph; Shamoon, Fayez

doi:10.1155/2015/739147

Cited by 13 publications

(17 citation statements)

References 8 publications

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“…The inoculum size of our tests was about 0.78 mm 3 mL -1 , 1.18 mm 3 mL -1 and 1.85 mm 3 mL -1 for 9%, 20% and 32% of inoculum size respectively, that correspond at 4.48 10E 6 cell mL -1 , 1.10 10E 7 cell mL -1 and 1.87 10E 7 cell mL -1 . In agreement with Lau et al (1995), (Lau, Tam, & Wong, 1995) the super concentrated culture of Chlorella vulgaris (with an initial inoculum of 1E107 cells mL -1 ) did not exhibit any self-shading limitation of growth and nutrient removal. Figure 3 shows algal growth for R1, enriched with CO 2 (350 ppm (v)) continuously for two months and the digestate was diluted according to the best results identified in the previously trials.…”

Section: Digestate Dilution and Microalgal Inoculum Testssupporting

confidence: 77%

Simulated Sofc Exhausts and Their Fixation on Chlorella Vulgaris: Study on Affecting Parameters

Papurello

Bressan

Bona³

et al. 2019

Detritus

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To curtail greenhouse gas emissions local and distributed energy systems should be fed by renewable and high efficiency fuels. Anaerobic digestate of organic waste from biogas production can be adopted as a substrate, coupled to Solid Oxide Fuel Cell (SOFC) exhausts, for biomass culture. This biorefinery concept can be exploited towards the complete integration of a waste treatment plant. The work concern the preliminary tests assessed to identify the condition to obtain microalgal growth on dry digestate from anaerobic digestion of organic waste and CO 2 remaining after power and heat production by fuel cells biofixation. The results of digestate pretreatment and dilution, inoculum: digestate ratio and CO 2 supply system were reported. Each test was controlling operating temperature and light intensity using a common green alga, Chlorella vulgaris. Different tests were performed for testing digestate dilution (from 1:20 to 1:70) and for defining microalgal inoculum concentration (9%, 20% and 32%). All trials were performed at laboratory scale. The optimal digestate pretreatment and microalgal inoculum concentration was used for achieving CO 2 biofixation in an experimental reactor (15 L). The best dilution for the digestate was found to be approximately 1:70 and inoculum percentage equal to 20%.

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Section: Digestate Dilution and Microalgal Inoculum Testssupporting

confidence: 77%

Simulated Sofc Exhausts and Their Fixation on Chlorella Vulgaris: Study on Affecting Parameters

Papurello

Bressan

Bona³

et al. 2019

Detritus

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“…However these changes had resolved following nasogastric suction along with her symptoms [12]. Inferolateral ST-segment elevation on a 12-lead ECG in a 42-year-old female, which had resolved rapidly after surgical decompression of intestinal distension, was also found in the literature [13]. …”

Section: Discussionmentioning

confidence: 90%

Gastric dilatation and intestinal obstruction mimicking acute coronary syndrome with dynamic electrocardiographic changes

Herath

Matthias

Keragala

et al. 2016

BMC Cardiovasc Disord

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BackgroundST elevation myocardial infarction is a medical emergency and the electrocardiogram is a part of the mainstay in the initial diagnosis. A variety of non-cardiac conditions have been known to mimic the electrocardiographic changes seen in acute coronary syndrome. We present a patient presenting with acute partial intestinal obstruction causing gastric distension and intestinal dilatation who also had dynamic electrocardiographic changes, mimicking anterior ST elevation myocardial infarction. Only very few cases of gastric distention and intestinal dilatation leading to acute ST segment elevation in electrocardiogram are reported so far in literature.Case presentationA fifty-six-year-old Sri Lankan male, without any modifiable risk factors for ischemic heart disease presented with acute onset nausea, vomiting, sweating, abdominal discomfort and fullness without any chest pain. On examination, he had a pulse rate of 50 beats per minute and his blood pressure was 110/50 mmHg. His abdomen was distended and the liver dullness was not detectable. Subsequent ECG showed > 2 mm ST elevations with T inversions in chest leads V1 to V3, J point elevation in leads L 11, L 111, aVF and T inversion in leads L 1 and aVL. Cardiac biomarkers were normal and 2D echo showed normal left ventricular function without any regional wall motion abnormalities. Abdominal X-ray showed a distended stomach, dilated ascending and descending colon with absent rectal air. Electrocardiographic changes reverted back to normal with the resolution of bowel obstruction.ConclusionThe mechanism of ECG changes in such a case like this is yet to be elucidated, but can be postulated to happen due to change in the position of the heart in the thoracic cavity causing change in the cardiac axis. This case emphasizes the importance of a proper history and highlights the value of auxiliary investigations such as cardiac biomarkers and echocardiogram in the diagnosis of acute coronary syndrome in a confusing situation such as this. This also illustrates the importance of early recognition of other noncardiac causes like acute gastric distention as being responsible for dynamic ECG changes. This will obviate a myriad of unnecessary investigations, interventions, costly management strategies and patient anxiety.

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Section: Discussionmentioning

confidence: 99%

“…Acute coronary syndrome with electrocardiographic changes and troponin elevation caused by bowel obstruction has been reported in rare cases [ 6 , 7 ] . In 1 case report, an adult female presented with epigastric pain and ST elevation ECG changes attributed to recurrent small bowel obstruction [ 6 ] . Other gastrointestinal pathologies, such as acute cholecystitis, have also been reported to cause ECG changes, alteration of the coronary blood supply and bradycardia, which can be attributed to stimulation of the vagus nerve [ 5 , 8 ] .…”

Section: Discussionmentioning

confidence: 99%

Ogilvie’s Syndrome Presented as Angina: A Case Report

Abdulazeez

Tran

2020

European Journal of Case Reports in Internal Medicine

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Ogilvie’s syndrome is a non-mechanical, acute pseudo-obstruction of the colon, causing massive colonic dilation. Medical or surgical conditions can predispose patients to Ogilvie’s syndrome; however, the pathogenesis and clinical findings are still not well understood. Here, we present a case of a 48-year-old male patient who presented to the Emergency Department with intermittent self-resolved left-sided lower chest pain on a background of ischaemic heart disease and positive risk factors for acute coronary syndrome. Troponin testing was negative and an electrocardiogram showed no acute changes. Chest radiography showed a dilated bowel under the left hemidiaphragm and a computed tomography (CT) scan of the abdomen-pelvis confirmed the diagnosis of Ogilvie’s syndrome. The patient was treated conservatively with a short period of nil by mouth and intravenous fluids.

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Small Bowel Obstruction Mimicking Acute ST-Elevation Myocardial Infarction

Cited by 13 publications

References 8 publications

Simulated Sofc Exhausts and Their Fixation on Chlorella Vulgaris: Study on Affecting Parameters

Simulated Sofc Exhausts and Their Fixation on Chlorella Vulgaris: Study on Affecting Parameters

Gastric dilatation and intestinal obstruction mimicking acute coronary syndrome with dynamic electrocardiographic changes

Ogilvie’s Syndrome Presented as Angina: A Case Report

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