Gastric perforation mimicking ST-segment elevation myocardial infarction.
Ryan Enast IntanFani Suslina HasibuanParama GandiFiras Farisi AlkaffPublished in: BMJ case reports (2021)
ST-elevation myocardial infarction (STEMI) is one of the medical emergencies in cardiology with high morbidity and mortality rate which requires rapid response. In elderly patients, its presenting symptoms may be atypical which may cause the diagnosis of MI to be delayed or missed. Therefore, ST-segment elevation on ECG has become the main instrument for initial diagnosis. However, there are a variety of conditions mimicking the ECG changes of STEMI. We report a case of 70-year-old patient with acute peritonitis and pneumoperitoneum secondary to gastric perforation with dynamic ECG changes mimicking anteroseptal STEMI. After the surgery, the ECG dynamically reverted to normal. He was then discharged after 4 days without any remaining symptoms. Misinterpretation of ECG findings may lead to unnecessary aggressive intervention, costly management strategies and delay in appropriate treatment.
Keyphrases
- percutaneous coronary intervention
- st elevation myocardial infarction
- st segment elevation myocardial infarction
- heart rate variability
- coronary artery bypass
- heart rate
- acute coronary syndrome
- coronary artery disease
- randomized controlled trial
- case report
- minimally invasive
- healthcare
- atrial fibrillation
- blood pressure
- intensive care unit
- sleep quality
- physical activity
- liver failure
- combination therapy