A potential diagnostic pitfall in acute chest pain: Massive pulmonary embolism mimicking acute ST elevation myocardial infarction.

Link to article at PubMed

A potential diagnostic pitfall in acute chest pain: Massive pulmonary embolism mimicking acute ST elevation myocardial infarction.

Am J Emerg Med. 2017 Nov 20;:

Authors: Lu YW, Tsai YL, Chang CC, Huang PH

Abstract
BACKGROUND: Pulmonary embolism (PE) represents a clinical challenge for clinicians because of nonspecific presentations, including dyspnea, chest pain, and tachycardia. The immediate 12-lead electrocardiogram (ECG) is commonly used to facilitate differential diagnosis of acute chest pain. Although relative rare, massive pulmonary embolism could induce ST segment elevation and mimic acute myocardial infarction.
CASE PRESENTATION: We present a challenging scenario that ECG showed ST segment elevation, nevertheless, urgent coronary angiogram revealed non-obstructive coronary artery disease. Unfortunately, the patient suffered from cardiac arrest and required extracorporeal membrane oxygenation devices. Finally, massive pulmonary embolism was diagnosed.
CONCLUSION: This case illustrates acute PE could mimic ST segment elevation myocardial infarction. ST elevations on ECG should be interpreted after considering clinical presentations before making a decision.

PMID: 29169886 [PubMed - as supplied by publisher]

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