Ya-Wen Lu1, Yi-Lin Tsai2, Chun-Chin Chang3, Po-Hsun Huang4. 1. Department of Medicine, Taipei Veterans General Hospital, Taiwan, ROC. 2. Department of Medicine, Taipei Veterans General Hospital, Taiwan, ROC; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan, ROC. 3. Department of Medicine, Taipei Veterans General Hospital, Taiwan, ROC; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan, ROC; Institute of Clinical Medicine, National Yang-Ming University, Taiwan, ROC. Electronic address: ccchang16@vghtpe.gov.tw. 4. Department of Medicine, Taipei Veterans General Hospital, Taiwan, ROC; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan, ROC; Institute of Clinical Medicine, National Yang-Ming University, Taiwan, ROC.
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.
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.