Pulmonary Embolism Presenting as an Anterior ST-elevation Myocardial Infarction: A Case Report

Clinical Practice and Cases in Emergency Medicine
Varvara LadageNicole Alexander-Anyaogu

Abstract

While the electrocardiogram (ECG) for pulmonary embolism typically shows tachycardia or evidence of right heart strain, it can demonstrate ischemic changes similar to acute coronary syndrome. The patient in this case presented with syncope, chest pain, and an ECG showing an anterior acute myocardial infarction (AMI) without evidence of right heart strain. His cardiac catheterization showed no coronary artery occlusions, but some signs of pulmonary embolism (PE), which was confirmed on computed tomography angiography of the chest. This case demonstrates that PE should be high on the differential for AMI and describes an uncommonly encountered mimic for classic ST-elevation myocardial infarction ECG changes. Further diagnostics to confirm the diagnosis should be obtained when indicated.

References

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Nov 24, 2005·JAMA : the Journal of the American Medical Association·Clifford J Swap, John T Nagurney
Dec 20, 2007·QJM : Monthly Journal of the Association of Physicians·J WestF Sampson
Nov 26, 2010·Cardiovascular Ultrasound·Tomaž Goslar, Matej Podbregar
Jun 11, 2011·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Rafael GolpeMaría Carmen Fariñas
Oct 12, 2011·Medical Principles and Practice : International Journal of the Kuwait University, Health Science Centre·Necla ÖzerSerdar Aksöyek
Jun 1, 2018·Case Reports in Critical Care·Amanda Grant-OrserWael Haddara

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