Acute Pancreatitis Mimicking ST-Segment Elevation Myocardial Infarction.

摘要: 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 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 leads II, III, and aVF, 2 mm ST V3 as shown figures. With concern for STEMI, he was taken left heart catheterization (LHC) emergently, showing nonobstructive coronary artery disease (CAD). laboratory workup remarkable lipase of 25,304 IU/l (normal level 8–78 IU/l). liver function test triglyceride normal. Troponin <0.01 ng/ml. computed tomographic exam abdomen revealed interstitial pancreatitis small discrete fluid collection uncinate process. He treated aggressive intravenous resuscitation discharged on day 3. Discussion. Intra-abdominal pathologies like can lead transient mimicking STEMI. It is important use clues, echocardiographic findings, clinical judgement avoid cardiac catheterization, contrast exposure, associated health care costs.