Minimal pneumothorax with dynamic changes in ST segment similar to myocardial infarction - 29/07/17

Doi : 10.1016/j.ajem.2017.04.037

Seok-Ran Yeom, MD, PhD ^a, Sung-Wook Park, MD ^a, Young-Dae Kim, MD, PhD ^b , Byung-Jae Ahn, MD ^c, Jin-Hee Ahn, MD ^d, Il-Jae Wang, MD ^a,^{^⁎}
^a Pusan National University Hospital, Department of Emergency Medicine, 179, Gudeok-ro, Seo-gu, Busan 602-739, South Korea
^b Pusan National University Hospital, Department of Thoracic and Cardiovascular Surgery, Pusan National University of College of Medicine, 179, Gudeok-ro, Seo-gu, Busan 602-739, South Korea
^c Pusan National University Hospital, Department of Internal Medicine, 179, Gudeok-ro, Seo-gu, Busan 602-739, South Korea
^d Pusan National University Hospital, Department of Cardiology, 179, Gudeok-ro, Seo-gu, Busan 602-739, South Korea

^⁎Corresponding author at: Pusan National University Hospital Department of Emergency Medicine, Biomedical Research Institute, Pusan National University Hospital, 179, Gudeok-ro, Seo-gu, Busan 602-739, South Korea.Pusan National University Hospital Department of Emergency MedicineBiomedical Research InstitutePusan National University Hospital179, Gudeok-ro, Seo-guBusan602-739South Korea

Abstract

Pneumothorax can cause a variety of electrocardiographic changes. ST segment elevation, which is mainly observed in myocardial infarction, can also be induced by pneumothorax. The mechanism is presumed to be a decrease in cardiac output, due to increased intra-thoracic pressure. We encountered a patient with ST segment elevation with minimal pneumothorax. Coronary angiography with ergonovine provocation test and echocardiogram had normal findings. The ST segment elevation was normalized by decreasing the amount of pneumothorax. We reviewed the literature and present possible mechanisms for this condition.

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Keywords : Pneumothorax, ST segment elevation, Electrocardiography, T wave inversion

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Vol 35 - N° 8

P. 1210.e1-1210.e4 - agosto 2017 Ritorno al numero

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Minimal pneumothorax with dynamic changes in ST segment similar to myocardial infarction - 29/07/17

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