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酷似心肌梗死的急性胰腺炎:一例具有挑战性的病例

Acute Pancreatitis Simulating Myocardial Infarction: A Challenging Case.

作者信息

Shiza Saher T, Parajuli Aalok, Samreen Iqra, Padullaparthi Tripura, Mohamed Alaa S, Haseeb Muhammad, Sadia Haleema, Mohamed Khalid H, Nasir Hira

机构信息

Internal Medicine, New York City Health and Hospitals - Lincoln Hospital, New York, USA.

Internal Medicine, Jalalabad Ragib Rabeya Medical College & Hospital, Jalalabad, BGD.

出版信息

Cureus. 2023 Apr 18;15(4):e37769. doi: 10.7759/cureus.37769. eCollection 2023 Apr.

Abstract

Acute pancreatitis is an inflammatory condition with varying local and systemic complications and variable severity. Although rare, cardiovascular complications induced by acute pancreatitis are rarely described in the literature. Epigastric pain with acute pancreatitis often simulates electrocardiographic changes in the absence of coronary artery abnormalities, resulting in a diagnostic dilemma for optimal treatment and management. We underline a case of acute pancreatitis complicated by acute coronary syndrome in a patient who presented with chest heaviness, dyspnea, nausea, and worsening epigastric pain associated with vomiting. Clinical and laboratory evaluations and using imaging modalities were suggestive of acute pancreatitis mimicking myocardial infarction (MI) in the absence of coronary artery abnormalities.

摘要

急性胰腺炎是一种伴有不同局部和全身并发症且严重程度各异的炎症性疾病。虽然罕见,但急性胰腺炎引发的心血管并发症在文献中鲜有描述。急性胰腺炎所致的上腹部疼痛在无冠状动脉异常时常常类似心电图改变,这给最佳治疗和管理带来了诊断难题。我们着重介绍一例急性胰腺炎合并急性冠状动脉综合征的病例,该患者表现为胸部闷痛、呼吸困难、恶心,以及伴有呕吐的上腹部疼痛加重。临床和实验室评估以及影像学检查提示,在无冠状动脉异常的情况下,急性胰腺炎酷似心肌梗死(MI)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5620/10194184/225bcb2fabd7/cureus-0015-00000037769-i01.jpg

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