title: [A deceptive gut feeling].
abstract: We report the case of a 58 year old man with unspecific lower abdominal pain, respiratory failure and shock. An acute aortic syndrome and a massive pulmonary embolism were excluded, and a coronary angiography for suspected acute myocardial infarction was performed, with detection of a high-grade stenosis of the left main coronary artery. A percutaneous coronary intervention was needed. We discuss the difficulty to distinguish an acute aortic syndrome, an acute coronary syndrome, and a massive pulmonary embolism in the emergency situation. In addition we discuss the difficulty of detecting a left main coronary artery stenosis in the ECG.
authors.affiliation: Medizinische Klinik, Stadtspital Waid, Zürich.
authors.forename: Simon A
authors.initials: SA
authors.lastname: Müggler
authors.forename: Michelle
authors.initials: M
authors.lastname: von Babo
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Iseli
authors.forename: Ivano
authors.initials: I
authors.lastname: Reho
authors.forename: Christian
authors.initials: C
authors.lastname: Giambarba
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003937:Diagnosis, Differential; D004417:Dyspnea / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000628:therapy; D012131:Respiratory Insufficiency / Q000209:etiology*; D012770:Shock, Cardiogenic / Q000175:diagnosis* / Q000628:therapy; D015607:Stents