scholarly journals Pancreatitis with Electrocardiographic Changes Mimicking Acute Myocardial Infarction

2001 ◽  
Vol 15 (8) ◽  
pp. 522-526 ◽  
Author(s):  
Paul Khairy ◽  
Pierre Marsolais
Keyword(s):  
Myocardial Infarction ◽  
Acute Pancreatitis ◽  
Epigastric Pain ◽  
Hemodynamic Instability ◽  
Anterior Myocardial Infarction ◽  
Cardiac Pathology ◽  
St Segment ◽  
Electrocardiographic Changes ◽  
Mild Acute Pancreatitis ◽  
New Onset

A 64-year-old woman with mild acute pancreatitis presented with epigastric pain, nausea and vomiting while undergoing hemodialysis for chronic renal insufficiency. Serial electrocardiograms revealed new onset ST segment elevations in leads V2 to V4 mimicking an anterior myocardial infarction, followed by diffusely inverted deep T waves. No cardiac pathology was demonstrated by echocardiography or coronary angiography. A review of the literature and possible pathophysiological mechanisms of electrocardiographic changes in acute pancreatitis, such as metabolic abnormalities, hemodynamic instability, vasopressors, pericarditis, myocarditis, a cardiobiliary reflex, exacerbation of underlying cardiac pathology, coagulopathy and coronary vasospasm, are discussed.

scholarly journals Acute Pancreatitis Masquerading as Inferior Wall Myocardial Infarction: A Review

2019 ◽  
Vol 13 (2) ◽  
pp. 321-335 ◽  
Author(s):  
Elliot S. Yu ◽  
Joel J. Lange ◽  
Apoorv Broor ◽  
Kesavan Kutty
Keyword(s):  
Myocardial Infarction ◽  
Acute Pancreatitis ◽  
Hemodynamic Instability ◽  
Inferior Wall ◽  
Ecg Changes ◽  
Rare Presentation ◽  
Diagnostic Dilemma ◽  
St Segment ◽  
High Acuity ◽  
History Of

A rare presentation of acute pancreatitis is with electrocardiographic (ECG) changes that mimic myocardial ischemia. We present a report of a patient that presented with hemodynamic instability and new ECG changes of ST segment elevations in contiguous leads II, III, and aVF mimicking an inferior wall myocardial infarction. Emergent coronary angiography showed no significant coronary obstruction, but it was followed by a left-sided hemiplegia with radiographic evidence of diffuse embolic stroke. The patient was later found to have an underlying diagnosis of pancreatitis. Additional history that later became available indicated a history of severe acute pancreatitis treated elsewhere a few months prior to the current admission. We present the first comprehensive review of the literature comprising 36 total cases with pancreatitis masquerading as acute myocardial infarction, with inferior wall STEMI pattern being the most frequent. We present this case to highlight the diagnostic dilemma posed by this masquerade of a high acuity myocardial infarction and to highlight alternative diagnoses to be considered in such clinical circumstances.

Fragmented QRS may predict new onset atrial fibrillation in patients with ST-segment elevation myocardial infarction

2018 ◽  
Vol 51 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Mahmut Yesin ◽  
Macit Kalçık ◽  
Metin Çağdaş ◽  
Yavuz Karabağ ◽  
İbrahim Rencüzoğulları ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Fragmented Qrs ◽  
St Segment ◽  
Onset Atrial Fibrillation ◽  
New Onset

scholarly journals Acute Pancreatitis Mimicking ST-Segment Elevation Myocardial Infarction

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Akanksha Agrawal ◽  
Nuzhat Sayyida ◽  
Jorge Luis Penalver ◽  
Mary R. Ziccardi
Keyword(s):  
Acute Pancreatitis ◽  
Sinus Bradycardia ◽  
Fluid Collection ◽  
Uncinate Process ◽  
Heart Catheterization ◽  
St Segment Elevation ◽  
Computed Tomographic ◽  
St Segment ◽  
Electrocardiographic Changes ◽  
Artery Disease

Introduction. Electrocardiographic changes imitating myocardial ischemia have been occasionally reported in patients with intra-abdominal pathology including acute pancreatitis. Case Report. A 60-year-old man with no past medical history presented to the emergency department (ED) after a syncopal episode. In ED, his vitals were stable. His ECG showed sinus bradycardia at 53 beats per minute, peaked T waves, 1 mm ST-segment elevation in leads II, III, and aVF, and 2 mm ST elevation in V3 as shown in the figures. With the concern for STEMI, he was taken for left heart catheterization (LHC) emergently, showing nonobstructive coronary artery disease (CAD). His laboratory workup was remarkable for lipase of 25,304 IU/l (normal level 8–78 IU/l). His liver function test and triglyceride level were normal. Troponin was <0.01 ng/ml. A computed tomographic exam of the abdomen revealed acute interstitial pancreatitis with a small discrete fluid collection in the uncinate process. He was treated with aggressive intravenous fluid resuscitation and was discharged on day 3. Discussion. Intra-abdominal pathologies like acute pancreatitis can lead to transient ECG changes mimicking STEMI. It is important to use ECG clues, echocardiographic findings, and clinical judgement to avoid cardiac catheterization, contrast exposure, and associated health care costs.

Impact of new-onset diabetes on clinical outcomes after ST segment-elevated myocardial infarction

2019 ◽  
Vol 53 (6) ◽  
pp. 379-384
Author(s):  
Ji-Yeoun Seo ◽  
Jin-Sun Park ◽  
Kyoung-Woo Seo ◽  
Hyoung-Mo Yang ◽  
Hong-Seok Lim ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Clinical Outcomes ◽  
Onset Diabetes ◽  
St Segment ◽  
New Onset
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