ST segment elevation on an electrocardiogram (EKG) is an alarming finding that warrants an urgent coronary angiogram. Early diagnosis and intervention is extremely important in the setting of Acute Coronary Syndrome (ACS) to prevent irreversible myocardium damage and reduce the mortality rate. However, it is very important to know that not all ST- Elevations (STE) on EKG are due to myocardial infraction. Etiologies can be divided into cardiac and non-cardiac causes. Cardiac causes can include coronary aneurysm and acute pericarditis while non-cardiac causes can include acute cholecystitis and pulmonary embolism. In this paper, we are presenting a unique case of a patient with inferior STE on EKG that was found to be induced by gastritis. Knowing that this condition exists will help prevent patients from undergoing unnecessary interventions.
Conflict(s) of Interest
References with DOI
1. Wang K, Asinger RW, Marriott HJ. ST-segment elevation in conditions other than acute myocardial infarction. N Engl J Med. 2003;349(22):2128-35. https://doi.org/10.1056/nejmra022580
2. Gu YL et al. Conditions mimicking acute ST-segment elevation myocardial infarction in patients referred for primary percutaneous coronary intervention. Neth Heart J. 2008;16(10):325-31. https://doi.org/10.1007/bf03086173
3. Gard JJ et al. Uncommon cause of ST elevation. Circulation. 2011;123(9):e259-61. https://doi.org/10.1161/circulationaha.110.002477
4. Patel K et al. Small bowel obstruction mimicking acute ST-elevation myocardial infarction. Case Rep Surg. 2015;2015:739147. https://doi.org/10.1155/2015/739147
5. Sethi P et al. ST segment elevation with normal coronaries. Case Rep Med. 2016;2016:3132654. https://doi.org/10.1155/2016/3132654
6. Heo WJ et al. Subarachnoid hemorrhage misdiagnosed as an acute ST elevation myocardial infarction. Korean Circ J. 2012;42(3):216-9. https://doi.org/10.4070/kcj.2012.42.3.216
7. Goslar T, Podbregar M. Acute ECG ST-segment elevation mimicking myocardial infarction in a patient with pulmonary embolism. Cardiovasc Ultrasound. 2010;8:50. https://doi.org/10.1186/1476-7120-8-50
8. Villablanca PA et al. Acute gastritis-induced Takotsubo's cardiomyopathy. Clin Case Rep. 2013;1(2):91-5. https://doi.org/10.1002/ccr3.32
9. Ro TK, Lang RM, Ward RP. Acute pancreatitis mimicking myocardial infarction: evaluation with myocardial contrast echocardiography. J Am Soc Echocardiogr. 2004;17(4):387-90. https://doi.org/10.1016/j.echo.2003.11.014
10. Makaryus AN, Adedeji O, Ali SK. Acute pancreatitis presenting as acute inferior wall ST-segment elevations on electrocardiography. Am J Emerg Med. 2008;26(6):734 e1-4. https://doi.org/10.1016/j.ajem.2007.11.008
11. Fox DJ, Grimm C, Curzen NP. Raised troponin T in acute cholecystitis. J R Soc Med. 2004;97(4):179. https://doi.org/10.1258/jrsm.97.4.179
12. Yu AC, Riegert-Johnson DL. A case of acute pancreatitis presenting with electrocardiographic signs of acute myocardial infarction. Pancreatology. 2003;3(6):515-7.Kearns J, Gundeti MS. Pediatric robotic urologic surgery-2014. J. Indian Assoc Pediatr Surg.2014;19(3):123-128. https://doi.org/10.4103/0971-9261.136456
Aqtash, Obadah; Amro, Ahmed; Gabi, Ala; Sobeih, Amal; El-Hamdani, Dr. Mehiar; and Thompson, Ellen A.
"Gastritis Induced ST Segment Elevation on Electrocardiogram,"
Marshall Journal of Medicine:
3, Article 6.
Available at: http://mds.marshall.edu/mjm/vol4/iss3/6