Acute ST-segment elevation also possible in non-coronary disorders

G.A.J. Jessurun, F. Zijlstra, H.J. Siebelink

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    Three patients were referred with symptoms or acute coronary syndrome. The ECG results indicated ST-segment elevation. A 39-year-old man had normal coronary arteries and was eventually diagnosed with pericarditis and myocarditis. A 71-year-old woman had ST-segment elevation caused by mechanical pressure from a chest drain that was inserted for a pneumothorax. A 62-year-old man was admitted to the intensive care unit and was found to have ST-segment elevation related to sepsis and non-significant coronary artery disease. All 3 patients recovered following adequate treatment. Percutaneous coronary intervention is the first choice therapy for ST-segment elevation myocardial infarction (STEMI). However, ST-segment elevation can also occur in patients with non-coronary disorders. Clinicians should be encouraged to scrutinise 'STEMI' as a referral diagnosis and check if there are signs of coronary mimicry, i.e. ECG changes due to a non-coronary underlying cause. The ECG changes should be considered in relation to the clinical data at presentation, rather than interpreted as a single diagnostic finding
    Original languageDutch
    Pages (from-to)937-942
    Number of pages6
    JournalNederlands Tijdschrift voor Geneeskunde
    Issue number17
    Publication statusPublished - 29-Apr-2006

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