title: Acute cholecystitis mimicking or accompanying cardiovascular disease among Japanese patients hospitalized in a Cardiology Department.
abstract: BACKGROUND
  Acute cholecystitis sometimes displays symptoms and electrocardiographic changes mimicking cardiovascular problems. It may also coexist with cardiovascular disorders. We analyzed the clinical characteristic of the cardiac patients who were diagnosed with acute cholecystitis during hospitalization in the cardiology department.
  
  
  METHODS
  Using the department database, we identified 16 patients who were diagnosed with acute cholecystitis during the hospitalization in the cardiology department between June 2010 and June 2014.
  
  
  RESULTS
  Five patients who were initially suspected to have cardiac problems (acute coronary syndrome, four patients; Adams-Stokes syndrome, one patient) owing to their symptoms were subsequently diagnosed with acute cholecystitis. Two of these patients showed electrocardiographic changes mimicking myocardial ischemia, and three tested positive for a biomarker (heart-type fatty acid binding protein) of acute myocardial injury. The 11 remaining cardiac patients were diagnosed with acute cholecystitis during their hospitalization or at the time of admission. Prolonged fasting and/or staying in an intensive care unit (ICU) may have contributed to their condition. Among these 11 patients, aortic dissection was the most prevalent underlying cardiac condition, affecting 5 patients.
  
  
  CONCLUSIONS
  Although it is a rare condition, acute cholecystitis may coexist with or be misdiagnosed as a cardiovascular disorder. This possibility should not be overlooked in cardiac patients because a delay in treatment may result in critical complications.
authors.affiliation: Department of Cardiology, Osaka Medical College, Takatsuki-shi Daigaku-machi 2-7, Osaka, 569-8686, Japan. in3105@poh.osaka-med.ac.jp.
authors.forename: Michishige
authors.initials: M
authors.lastname: Ozeki
authors.affiliation: Department of Cardiology, Osaka Medical College, Takatsuki-shi Daigaku-machi 2-7, Osaka, 569-8686, Japan. in1231@poh.osaka-med.ac.jp.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Takeda
authors.affiliation: Department of Cardiology, Osaka Medical College, Takatsuki-shi Daigaku-machi 2-7, Osaka, 569-8686, Japan. in3068@poh.osaka-med.ac.jp.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Morita
authors.affiliation: Department of Cardiology, Osaka Medical College, Takatsuki-shi Daigaku-machi 2-7, Osaka, 569-8686, Japan. in3071@poh.osaka-med.ac.jp.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Miyamura
authors.affiliation: Department of Cardiology, Osaka Medical College, Takatsuki-shi Daigaku-machi 2-7, Osaka, 569-8686, Japan. in3025@poh.osaka-med.ac.jp.
authors.forename: Koichi
authors.initials: K
authors.lastname: Sohmiya
authors.affiliation: Department of Cardiology, Osaka Medical College, Takatsuki-shi Daigaku-machi 2-7, Osaka, 569-8686, Japan. in1026@poh.osaka-med.ac.jp.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Hoshiga
authors.affiliation: Department of Cardiology, Osaka Medical College, Takatsuki-shi Daigaku-machi 2-7, Osaka, 569-8686, Japan. ishizaka@osaka-med.ac.jp.
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Ishizaka
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000453:epidemiology; D000368:Aged; D016507:Cardiology Service, Hospital / Q000706:statistics & numerical data*; D041881:Cholecystitis, Acute / Q000175:diagnosis* / Q000453:epidemiology; D015897:Comorbidity; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan; D008297:Male