Acute Pancreatitis Simulating Myocardial Infarction: A Challenging Case

Abstract

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.

Myopericarditis Mimicking an Acute MI

“…Chest pain with ST elevations in contigious leads is usually considered to be acute myocardial infarction (MI) until proven otherwise. However, ST elevations are not pathognomonic to MI; there are other conditions like pericarditis [2], pulmonary embolism, pneumothorax, subarachnoid hemorrhage, hypertrophic and takotsubo cardiomyopathy, aortic dissection, and acute pancreatitis that can also cause ST elevations [3][4][5][6]. ST elevation on an electrocardiogram can be the presenting sign of a diagnosis that carries a poor prognosis if not managed promptly.…”