title: Left spontaneous pneumothorax presenting with ST-segment elevations: a case report and review of the literature.
abstract: Common electrocardiogram (ECG) changes associated with left-sided pneumothorax include right axis deviation, reduced R-wave amplitude in precordial leads, QRS alterations (amplitude changes), and T-wave inversions. Few reports exist of ST-segment elevations or changes suggestive of acute myocardial infarction (AMI), and these involve older patients with tension pneumothorax and previous coronary heart disease. We report on a young man with no significant medical history, presenting with left-sided spontaneous pneumothorax and ECG changes that included ST-segment elevations and T-wave inversions in the precordial leads, reminiscent of AMI. All changes resolved after decompression of the pneumothorax. On the basis of the patient's presenting symptoms, response to therapy, and our review of the literature, we propose a number of possible mechanisms explaining his electrocardiographic findings.
authors.affiliation: Department of Internal Medicine, Soroka University Medical Center, Beer Sheva, Israel. arthur.shiyovich@gmail.com
authors.forename: Arthur
authors.initials: A
authors.lastname: Shiyovich
authors.forename: Zeldetz
authors.initials: Z
authors.lastname: Vladimir
authors.forename: Lior
authors.initials: L
authors.lastname: Nesher
mesh_terms: D015505:Chest Tubes; D019299:Decompression, Surgical; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000295:instrumentation; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000473:pathology; D011030:Pneumothorax / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D055815:Young Adult