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Acute Gastric Perforation Mimicking ST-Elevation Myocardial Infarction

Published:October 13, 2022DOI:https://doi.org/10.1016/j.amjmed.2022.09.020
      An ST-elevation myocardial infarction (STEMI) is a medical emergency with an electrocardiogram (ECG) as the primary tool for rapid identification. Although STEMIs are known to produce characteristic ECG changes, several life-threatening conditions may mimic classic ECG patterns. In this article, we report a case of a 68-year-old male with a pneumoperitoneum secondary to gastric perforation with symptoms and ECG changes consistent with an inferior STEMI.
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      References

        • Park J
        • Choi KH
        • Lee JM
        • et al.
        Prognostic implications of door-to-balloon time and onset-to-door time on mortality in patients with ST-segment-elevation myocardial infarction treated with primary percutaneous coronary intervention.
        J Am Heart Assoc. 2019; 8e012188https://doi.org/10.1161/JAHA.119.012188
        • Loncharich MF
        • Anderson CW.
        Interferon inhibition for lupus with anifrolumab: critical appraisal of the evidence leading to FDA approval.
        ACR Open Rheumatol. 2022; 4: 486-491https://doi.org/10.1002/acr2.11414
        • Pezzilli R
        • Barakat B
        • Billi P
        • Bertaccini B.
        Electrocardiographic abnormalities in acute pancreatitis.
        Eur J Emerg Med. 1999; 6: 27-29
        • Ryan ET
        • Pak PH
        • DeSanctis RW.
        Myocardial infarction mimicked by acute cholecystitis.
        Ann Intern Med. 1992; 116: 218-220https://doi.org/10.7326/0003-4819-116-3-218
        • Zhang J
        • Basrawala H
        • Patel S
        • et al.
        Gastrointestinal distention masquerading as ST-segment elevation myocardial infarction.
        JACC Case Rep. 2020; 2: 604-610https://doi.org/10.1016/j.jaccas.2020.02.016
        • Intan RE
        • Hasibuan FS
        • Gandi P
        • Alkaff FF.
        Gastric perforation mimicking ST-segment elevation myocardial infarction.
        BMJ Case Rep. 2021; 14e237470https://doi.org/10.1136/bcr-2020-237470
        • Duke M.
        Positional effects of gastric distention upon the mean electrical axis of the QRS complex of the electrocardiogram.
        Vasc Dis. 1965; 2: 161-167
        • Chapleau MW
        • Sabharwal R.
        Methods of assessing vagus nerve activity and reflexes.
        Heart Fail Rev. 2011; 16: 109-127https://doi.org/10.1007/s10741-010-9174-6