Armas Cristian D, Bademian Sean, Kcomt Mikaela, Burgess Jessica, Qiao Xian
School of Medicine, National University of Trujillo, Av. Roma 338, Trujillo 13011, Peru.
Department of Internal Medicine, Division of Pulmonary Disease and Critical Care, Eastern Virginia Medical School, 825 Fairfax Ave, Norfolk, VA 23507, United States.
Oxf Med Case Reports. 2024 Jul 30;2024(7):omae080. doi: 10.1093/omcr/omae080. eCollection 2024 Jul.
Acute abdominal pathologies can cause electrocardiogram (ECG) changes mimicking an acute coronary syndrome (ACS), resulting in diagnostic uncertainty and delay. We report a 65-year-old male with multiple risk factors for ACS who presented with four hours of progressive epigastric and chest pain that resolved in the emergency department. ECG findings were concerning for new deeply inverted T-waves with normal troponins, raising concerns for Wellens Syndrome. Emergent heart catheterization was negative but abdominal computed tomography angiography showed occlusion of the superior mesenteric vessels. Subsequent exploratory laparotomy revealed a small bowel volvulus with extensive necrosis, resulting in a 430 cm resection.
急性腹部病变可导致心电图（ECG）改变，酷似急性冠状动脉综合征（ACS），从而造成诊断上的不确定性并导致延误。我们报告一名65岁男性，有多项ACS危险因素，因进行性上腹部和胸痛4小时就诊，在急诊科症状缓解。心电图表现为新出现的深倒置T波且肌钙蛋白正常，令人担心Wellens综合征。急诊心脏导管检查结果为阴性，但腹部计算机断层血管造影显示肠系膜上血管闭塞。随后的剖腹探查发现小肠扭转伴广泛坏死，遂行430厘米肠段切除术。
