Division of Acute Care Surgery, Trauma, and Surgical Critical Care, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
J Emerg Med. 2020 Apr;58(4):673-676. doi: 10.1016/j.jemermed.2019.12.027. Epub 2020 Jan 27.
Ingestion of cylindrical batteries is uncommon. Management can include removal via upper endoscopy, surgical excision, or observation. This case demonstrates the rare phenomenon of cylindrical battery ingestion causing an electrocardiogram (ECG) artifact that mimics ST segment myocardial infarction (STEMI).
A 51-year-old man who ingested 13 small pencils and 18 AA batteries was found to have ST segment elevation in the inferior leads of the ECG. Further cardiac workup including cardiac biomarkers and transthoracic echocardiogram was negative, and his ECG changes resolved after extraction of the batteries. The ST segment changes were most likely caused by electrical artifact from battery ingestion. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: When faced with an ECG finding that is unexpected and that does not fit the patient's overall clinical picture, emergency physicians should consider artifact as a possible cause. Recognition of artifact as the cause of an ECG abnormality can obviate the need for a prolonged and potentially invasive cardiac workup.
吞食圆柱形电池并不常见。其处理方法包括通过上内窥镜检查、手术切除或观察。本案例展示了一个罕见的现象，即吞食圆柱形电池导致心电图（ECG）伪影，类似于 ST 段抬高型心肌梗死（STEMI）。
一名 51 岁男性吞食了 13 支小铅笔和 18 节 AA 电池，心电图下壁导联出现 ST 段抬高。进一步的心脏检查包括心脏标志物和经胸超声心动图均为阴性，电池取出后心电图改变得到缓解。ST 段改变很可能是由电池摄入引起的电伪影所致。
为什么急诊医生应该注意这一点？：当面对与患者整体临床情况不符且出乎意料的心电图发现时，急诊医生应考虑伪影作为可能的原因。识别心电图异常是由伪影引起的，可以避免进行冗长且可能具有侵入性的心脏检查。
