Upadhyay Ankit, Chauhan Sudheer, Jangda Umair, Bodar Vipul, Al-Chalabi Ahmed
Department of Medicine, Jamaica Hospital Medical Center, Jamaica, NY 11418, USA.
Case Rep Med. 2017;2017:5982910. doi: 10.1155/2017/5982910. Epub 2017 Mar 30.
ST-segment elevation is an important and alarming electrocardiographic sign that necessitates immediate attention but does not always indicate that the primary pathology is cardiac in origin. It needs to be interpreted in the clinical context as several pathological conditions involving especially gastrointestinal tract may lead to delayed diagnosis and treatment as well as complications from invasive unnecessary interventions. We present two patients, a 64-year-old male and a 71-year-old female, who were admitted to the emergency room of a community-based hospital with similar complaints of worsening epigastric abdominal pain and were diagnosed later with small bowel obstruction. Both patients reported a history of abdominal surgeries in the past. Also in both patients the ECG showed signs of ST-segment elevation in inferior and lateral leads. These ECG changes were related to the intra-abdominal pathology as no evidence of contributing coronary artery disease could be found. In addition, prompt resolution of ST-segment elevation was seen after surgical treatment. The pathophysiological etiology of electrocardiographic changes accompanying small bowel obstruction is yet to be explored.
ST段抬高是一种重要且令人担忧的心电图表现，需要立即关注，但它并不总是表明主要病变源于心脏。需要结合临床情况进行解读，因为一些特别是涉及胃肠道的病理状况可能导致诊断和治疗延迟以及不必要的侵入性干预引发并发症。我们介绍两名患者，一名64岁男性和一名71岁女性，他们因上腹部疼痛加重的类似症状被收治到一家社区医院的急诊室，后来被诊断为小肠梗阻。两名患者均有既往腹部手术史。两名患者的心电图在下壁和侧壁导联均显示ST段抬高迹象。这些心电图变化与腹内病变有关，因为未发现冠状动脉疾病的相关证据。此外，手术治疗后ST段抬高迅速缓解。小肠梗阻伴发心电图变化的病理生理病因尚待探索。
