Emphysematous pyelonephritis with ST elevation accompanied by reciprocal changes mimicking acute coronary syndrome.

Humans Acute Coronary Syndrome / complications Coronary Artery Disease ST Elevation Myocardial Infarction / diagnosis Electrocardiography / methods Arrhythmias, Cardiac Pyelonephritis / complications Sepsis Coronary Angiography
Emphysematous pyelonephritis Reciprocal ST change ST-elevation

Journal

The American journal of emergency medicine
ISSN: 1532-8171
Titre abrégé: Am J Emerg Med
Pays: United States
ID NLM: 8309942

Informations de publication

Date de publication:
08 2023
Historique:
received: 14 06 2023
accepted: 19 06 2023
medline: 25 7 2023
pubmed: 10 7 2023
entrez: 9 7 2023
Statut: ppublish

Résumé

Patients with infectious diseases including sepsis can develop ST segment changes on an electrocardiogram (ECG) in the absence of coronary artery disease. However, ST elevation with "reciprocal ST segment depression (RSTD)", which is recognized as a specific finding for ST-elevated myocardial infarction, is rare in such patients. Although a small number of cases have reported ST-segment elevation in gastritis, cholecystitis, and sepsis, regardless of coronary artery disease, none presented with reciprocal changes. Here, we describe a rare case of a patient with emphysematous pyelonephritis complicating septic shock who developed ST elevation accompanied by reciprocal changes with no coronary occlusion. Emergency physicians should consider the possibility of acute coronary syndrome mimicking, and choose non-invasive diagnostic procedures when investigating the causes of ECG abnormalities associated with critically ill patients.

Identifiants

DOI: 10.1016/j.ajem.2023.06.038 PMID: 37423820
pubmed: 37423820
pii: S0735-6757(23)00330-3
doi: 10.1016/j.ajem.2023.06.038
pii:
doi:

Types de publication

Case Reports

Langues

eng

Sous-ensembles de citation

IM

Pagination

208.e5-208.e7

Informations de copyright

Copyright © 2023 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest None to report.

Auteurs

Kiwamu Hatakeyama (K)

Emergency and Critical Care Center, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan.

Yuji Shono (Y)

Emergency and Critical Care Center, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan. Electronic address: shono.yuji.779@m.kyushu-u.ac.jp.

Takuma Hashimoto (T)

Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Taiki Sakamoto (T)

Emergency and Critical Care Center, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan; Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.

Masaaki Nishihara (M)

Emergency and Critical Care Center, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan; Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.

Takeshi Iyonaga (T)

Emergency and Critical Care Center, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan; Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.

Soichi Mizuguchi (S)

Emergency and Critical Care Center, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan.

Takafumi Sakamoto (T)

Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.

Jun Maki (J)

Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Tomohiko Akahoshi (T)

Emergency and Critical Care Center, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Emphysematous pyelonephritis with ST elevation...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Ischémie myocardique › Syndrome coronarien aigu › Emphysematous pyelonephritis with ST elevation...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Ischémie myocardique › Maladie coronarienne › Maladie des artères coronaires › Emphysematous pyelonephritis with ST elevation...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Nécrose › Infarctus › Infarctus du myocarde › Infarctus du myocarde avec sus-décalage du segment ST › Emphysematous pyelonephritis with ST elevation...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Électrodiagnostic › Électrocardiographie › Emphysematous pyelonephritis with ST elevation...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Troubles du rythme cardiaque › Emphysematous pyelonephritis with ST elevation...
questionsmedicales.fr › Maladies urogénitales › Maladies urologiques › Maladies du rein › Néphrite › Pyélite › Pyélonéphrite › Emphysematous pyelonephritis with ST elevation...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Inflammation › Sepsie › Emphysematous pyelonephritis with ST elevation...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Techniques de diagnostic cardiovasculaire › Tests de la fonction cardiaque › Coronarographie › Emphysematous pyelonephritis with ST elevation...