Acute Pancreatitis Mimicking ST-Segment Elevation Myocardial Infarction

Agrawal, Akanksha; Sayyida, Nuzhat; Peñalver, Jorge; Ziccardi, Mary Rodriguez

doi:10.1155/2018/9382904

Cited by 9 publications

(8 citation statements)

References 17 publications

(19 reference statements)

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“…Although rare, cardiovascular complications can also occur in patients with acute pancreatitis, which include hypovolemia, pericardial effusion, shock or worsening of underlying ischemic heart disease, or heart failure [4]. Rarely acute pancreatitis can also be associated with many EKG changes, including arrhythmias and changes in T wave and ST-segment elevation mimicking myocardial infarction, which is not widely reported in the literature [5][6][7][8][9][10]. We have tabulated acute pancreatitis-induced cardiovascular complications in The pathophysiology of acute pancreatitis-induced MI is complex and not fully understood.…”

Section: Discussionmentioning

confidence: 99%

Acute Pancreatitis Simulating Myocardial Infarction: A Challenging Case

Shiza¹,

Parajuli²,

Samreen³

et al. 2023

Cureus

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Acute pancreatitis is an inflammatory condition with varying local and systemic complications and variable severity. Although rare, cardiovascular complications induced by acute pancreatitis are rarely described in the literature. Epigastric pain with acute pancreatitis often simulates electrocardiographic changes in the absence of coronary artery abnormalities, resulting in a diagnostic dilemma for optimal treatment and management. We underline a case of acute pancreatitis complicated by acute coronary syndrome in a patient who presented with chest heaviness, dyspnea, nausea, and worsening epigastric pain associated with vomiting. Clinical and laboratory evaluations and using imaging modalities were suggestive of acute pancreatitis mimicking myocardial infarction (MI) in the absence of coronary artery abnormalities.

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Section: Discussionmentioning

confidence: 99%

Acute Pancreatitis Simulating Myocardial Infarction: A Challenging Case

Shiza¹,

Parajuli²,

Samreen³

et al. 2023

Cureus

View full text Add to dashboard Cite

show abstract

“…8,11) Other abdominal diseases such as acute cholecystitis, acute pancreatitis, and ulcer can induce ST-segment change and sinus bradycardia or complete atrioventricular block. [12][13][14][15] What is the mechanism of non-cardiac-driven ECG alterations? As expected, elevated cardiac sympathetic tone and excessive catecholamine production are believed to be central in causing ECG changes.…”

Section: Article P814mentioning

confidence: 99%

Non-Cardiac Organs Metamorphose Heart

Oshima

Fujiu

2022

Int. Heart J.

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“…The symptoms and signs of acute pancreatitis can mimic those of acute coronary syndrome (ACS), including epigastric or chest discomfort (angina), nausea, vomiting, and syncope. This makes the diagnosis more difficult when there is ST-segment elevation and a worry about ischemia [ 40 ]. Minor ECG changes that can be produced by pancreatitis can be a T wave inversion, ST-segment depression, and ST-segment elevation in the absence of underlying cardiac pathology [ 41 ].…”

Section: Reviewmentioning

confidence: 99%

ST-Segment Elevation in Conditions of Non-cardiovascular Origin Mimicking an Acute Myocardial Infarction: A Narrative Review

Khurana¹,

Ranjan²

2022

Cureus

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The most widespread presenting ailments among patients visiting the emergency department are chest pain and shortness of breath. These symptoms lead any doctor to a probable diagnosis of myocardial infarction (MI). Detailed patient history, testing of blood samples for cardiac biomarkers that are indicative of cardiovascular necrosis, ultrasound methods, electrocardiography, and coronary computed tomography (CT) could all be beneficial to support the diagnosis. Out of these, electrocardiography is the most important and commonly done investigation in the emergency departments for patients presenting with chest pain and shortness of breath. However, interpreting these patients' electrocardiograms (ECGs) may be a matter of concern and worry. T wave and ST-segment changes are often of interest in the early signs of myocardial ischemia. Despite its incredible sensitivity, ST-segment deviation (elevated or depressed) has a low specificity because it can be seen in a variety of other cardiac and non-cardiac diseases. When ST-segment anomalies are identified, clinicians must consider many additional characteristics (such as risk factors, symptoms, and anamnesis), as well as all other possible diagnoses.All of these scenarios of patients presenting in the emergency department with chest discomfort and shortness of breath showing ST-segment abnormalities can leave a healthcare professional wondering whether to start treatment for acute myocardial infarction, through either the administration of a fibrinolytic agent, exposing patients to both the benefits and risks of fibrinolysis, or invasive coronary angiography. An astute physician may be able to recognize fabricated differential diagnosis mimicking STsegment elevation myocardial infarction (STEMI) in some situations. Failure to recognize these imposters can result in inefficient resource utilization, which can expose patients to unjustified risk and increased rather than decreased death and morbidity. Since the danger of cerebral hemorrhage from blood thinners is significant, in patient-care scenarios, in order to rule out percutaneous coronary intervention (PCI), a thorough assessment of the ECG is essential to consider diseases other than acute myocardial infarction, especially the ones that are non-cardiac in origin. The goal of this narrative review is to give an overview of the significant disorders that are non-cardiac in origin that can mimic an ST-segment elevation myocardial infarction (STEMI).

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Acute Pancreatitis Mimicking ST-Segment Elevation Myocardial Infarction

Cited by 9 publications

References 17 publications

Acute Pancreatitis Simulating Myocardial Infarction: A Challenging Case

Acute Pancreatitis Simulating Myocardial Infarction: A Challenging Case

Non-Cardiac Organs Metamorphose Heart

ST-Segment Elevation in Conditions of Non-cardiovascular Origin Mimicking an Acute Myocardial Infarction: A Narrative Review

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