Demarchi Marco Stefano, Regusci Luca, Fasolini Fabrizio
Department of Surgery, Ospedale Beata Vergine, Mendrisio, Switzerland.
Case Rep Gastroenterol. 2012 May;6(2):410-4. doi: 10.1159/000339965. Epub 2012 Jun 26.
Cardiac troponins are the most sensitive and specific serum markers of myocardial cell injury, but they can also arise without apparent cardiac injury. Besides, acute cholecystitis may be associated with nonspecific ST-T wave changes in electrocardiography (ECG). The signs and symptoms of gallbladder and heart disease may overlap, which can make diagnosis difficult. We describe the case of a 75-year-old woman with clinical features suggestive of acute cholecystitis associated with transient ST segment elevation and elevated troponin I that, after extensive workup, did not seem to be attributable to myocardial ischemia or any other acute cardiac problem, but were exclusively related to cholecystitis. We show that cholecystitis with gallbladder distension can be the sole cause of pathological ECG changes and an increased troponin I level; this should be considered when evaluating patients with similar presentations.
心肌肌钙蛋白是心肌细胞损伤最敏感和特异的血清标志物，但它们也可能在无明显心脏损伤的情况下出现。此外，急性胆囊炎可能与心电图（ECG）的非特异性ST-T波改变有关。胆囊疾病和心脏疾病的体征和症状可能重叠，这会使诊断变得困难。我们描述了一例75岁女性患者的病例，其临床特征提示急性胆囊炎伴短暂性ST段抬高和肌钙蛋白I升高，经过全面检查，这些表现似乎并非由心肌缺血或任何其他急性心脏问题引起，而是仅与胆囊炎有关。我们表明，伴有胆囊扩张的胆囊炎可能是病理性心电图改变和肌钙蛋白I水平升高的唯一原因；在评估有类似表现的患者时应考虑到这一点。
