When you hear hoofbeats, think of horses but do not forget the zebras

BMJ Case Reports
Anders Stochholm, Brian Bridal Løgstrup

Abstract

We report a case of a 68-year-old man who was admitted to the department of cardiology with increasing abdominal and chest pain during the day. The prehospital ECG showed clear ST segment elevation in inferior leads. The patient was routed directly to the catheterisation laboratory with acute myocardial infarction as a tentative diagnosis. The coronary angiography showed an occluded right coronary artery that was reopened with a plain old balloon angioplasty procedure. After the procedure, the patient was expected to feel better, but the abdominal pain worsened. The following bedside ultrasound examination was quite surprising.

References

Oct 24, 2009·Gender Medicine·Johanna BergAnnika Rosengren
Oct 18, 2011·Heart & Lung : the Journal of Critical Care·Linda L CoventryAlexandra P Bremner
Sep 13, 2013·Journal of Cardiovascular Disease Research·Lovleen C Bhatia, Ruchi H Naik
Nov 18, 2014·Cardiology·Karthiek NaralaSudhir Mungee

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