Article

Chest pain and ST elevation: not always ST-segment-elevation myocardial infarction.

Cardiovascular Department, Ospedali Riuniti and University of Trieste, Trieste, Italy.
Journal of Cardiovascular Medicine (impact factor: 1.51). 12/2009; 11(8):615-8. DOI:10.2459/JCM.0b013e3283317908 pp.615-8
Source: PubMed

ABSTRACT A 59-year-old male patient affected by pleural mesothelioma presented with chest pain and localized ST elevation in the electrocardiogram. Urgent coronary angiography excluded an acute coronary occlusion, whereas high-resolution computed tomography of the chest revealed tumor infiltration and associated acute inflammation of the pericardial sac. This case illustrates how initial clinical evaluation during emergency conditions could be misled by the time-effectiveness imperative in the primary percutaneous coronary intervention era. In conclusion, early valorization of clinical signs and noninvasive diagnostic elements may add accuracy in directing the postadmission patient course.

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Keywords

59-year-old male patient
 
acute coronary occlusion
 
acute inflammation
 
high-resolution computed tomography
 
initial clinical evaluation
 
localized ST elevation
 
noninvasive diagnostic elements
 
primary percutaneous coronary intervention era
 
time-effectiveness imperative
 
Urgent coronary angiography
 
valorization