10p for an angiogram: the cardio-oesophageal reflex.
A 57-year-old man presented at our institution with central chest pain. Serial ECGs showed dynamic T-wave changes, suggesting the possibility of unstable angina. Urgent coronary angiography revealed an unexpected finding of a radio-opaque lesion seen in the xiphisternal region during screening. Oesophogastroduodenoscopy confirmed this to be a 10p coin. The coin passed through the gastrointestinal tract without complications and the patient's symptoms and ECG changes resolved. This unusual case is a reminder that many diseases may electrocardiographically imitate an acute coronary syndrome.
Department of Cardiology, Royal United Hospital, Bath, UK. raveenkandan@gmail.com
S R
SR
Kandan
D X
DX
Augustine
R J
RJ
Mansfield
J
J
Easaw
D054058:Acute Coronary Syndrome / Q000175:diagnosis; D000789:Angina, Unstable / Q000175:diagnosis*; D002637:Chest Pain / Q000000981:diagnostic imaging* / Q000209:etiology*; D017023:Coronary Angiography; D003937:Diagnosis, Differential; D004562:Electrocardiography; D016145:Endoscopy, Digestive System; D004947:Esophagus; D005547:Foreign Bodies / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013249:Sternum; D014989:Xiphoid Bone