title: Spontaneous Rupture of Hepatocellular Carcinoma Mimicking ST-Segment Elevation Myocardial Infarction.
abstract: BACKGROUND
  Several medical conditions that mimic ST-elevation myocardial infarction (STEMI) have been reported previously, but acute abdominal disease mimicking STEMI is rare.
  
  
  METHODS
  We report on a 72-year-old man who presented to the emergency department (ED) with epigastric pain. Meanwhile, STEMI with shock developed. Anticoagulation medication and emergent percutaneous coronary intervention (PCI) were arranged in a timely manner. However, hepatocellular carcinoma (HCC) rupture was the true cause of the ST-segment elevation. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case report highlights the fact that acute myocardial infarction is not the only cause of ST-segment elevation. HCC rupture should be one of the differential diagnoses.
authors.affiliation: Department of Emergency Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan and Department of Emergency Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Kai-Yi
authors.initials: KY
authors.lastname: Huang
authors.affiliation: Department of Emergency Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan and Department of Emergency Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Ming-Che
authors.initials: MC
authors.lastname: Tsai
authors.affiliation: Department of Emergency Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan and Department of Emergency Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Chao-Bin
authors.initials: CB
authors.lastname: Yeh
authors.affiliation: Department of Emergency Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan and Department of Emergency Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Sai-Wai
authors.initials: SW
authors.lastname: Ho
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004562:Electrocardiography; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis*; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000209:etiology; D012422:Rupture, Spontaneous / Q000150:complications / Q000175:diagnosis
keywords: ST-segment elevation; hepatocellular carcinoma rupture; myocardial infarction