Department of Cardiology, Tampere University Hospital Heart Center, PO Box 2000, FI-33521 Tampere, Finland.
Am J Emerg Med. 2012 Jan;30(1):256.e3-6. doi: 10.1016/j.ajem.2010.10.021. Epub 2010 Dec 3.
ST-elevation myocardial infarction (STEMI) is an emergency situation in which immediate measures for myocardial reperfusion are needed. The diagnosis is based on the recognition of ST-segment elevation in the electrocardiogram (ECG). In case of coronary artery occlusion, ST-segment elevation is caused by an injury current from the ischemic myocardium. Rarely, other mechanisms may lead to ECG changes mimicking STEMI. In our case, a 65-year-old man was presented to our institution with ECG abnormalities suggestive of STEMI. However, coronary angiography showed open arteries. Laboratory tests revealed severe hypocalcemia caused by a deficiency of vitamin D. After calcium replacement therapy, the ECG normalized, and the patient was discharged in good condition. Only a few case reports on hypocalcemia-induced ST-segment elevation exist, and the mechanism remains unknown.
ST 段抬高型心肌梗死（STEMI）是一种紧急情况，需要立即采取心肌再灌注措施。诊断基于心电图（ECG）中 ST 段抬高的识别。在冠状动脉闭塞的情况下，ST 段抬高是由缺血心肌的损伤电流引起的。很少有其他机制会导致 ECG 变化类似于 STEMI。在我们的病例中，一名 65 岁男性因 ECG 异常就诊，提示 STEMI。然而，冠状动脉造影显示动脉通畅。实验室检查显示维生素 D 缺乏引起的严重低钙血症。钙替代治疗后，心电图恢复正常，患者状况良好出院。只有少数关于低钙血症引起的 ST 段抬高的病例报告，其机制尚不清楚。
