[Acute ST-segment elevation also possible in non-coronary disorders].
Three patients were referred with symptoms of acute coronary syndrome. The ECG results indicated ST-segment elevation. A 39-year-old man had normal coronary arteries and was eventually diagnosed with pericarditis and myocarditis. A 71-year-old woman had ST-segment elevation caused by mechanical pressure from a chest drain that was inserted for a pneumothorax. A 62-year-old man was admitted to the intensive care unit and was found to have ST-segment elevation related to sepsis and non-significant coronary artery disease. All 3 patients recovered following adequate treatment. Percutaneous coronary intervention is the first choice therapy for ST-segment elevation myocardial infarction (STEMI). However, ST-segment elevation can also occur in patients with non-coronary disorders. Clinicians should be encouraged to scrutinise 'STEMI' as a referral diagnosis and check if there are signs of coronary mimicry, i.e. ECG changes due to a non-coronary underlying cause. The ECG changes should be considered in relation to the clinical data at presentation, rather than interpreted as a single diagnostic finding.
Jessurun
G A J
GA
Universitair Medisch Centrum Groningen, Thoraxcentrum, afd. Cardiologie, Postbus 30.001, 9700 RB Groningen.
Zijlstra
F
F
Siebelink
H J
HJ
D000208:Acute Disease; D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000175:diagnosis; D003937:Diagnosis, Differential; D004562:Electrocardiography; D004568:Electrodiagnosis / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000150:complications / Q000175:diagnosis*; D010493:Pericarditis / Q000150:complications / Q000175:diagnosis*; D011312:Pressure; D018805:Sepsis / Q000150:complications / Q000175:diagnosis*