Case report


Perforated gastric ulcer with ST-segment elevation mimicking acute myocardial infarction

Wasawat Vutthikraivit MD

ABSTRACT

A 78-year-old man presented to the emergency department with severe epigastric pain. An electrocardiogram showed ST-segment elevation in leads V2 and V3 consistent with acute myocardial ischemia. He denied any underlying disease. On physical examination, his abdomen had hypoactive bowel sounds, diffuse rebound tenderness, and muscle guarding. An upright abdominal x-ray showed pneumoperitoneum, and emergency laparotomy was done. We present a case of perforated gastric ulcer presenting with ST-segment elevation with documented normal coronary arteries. The ST-segment elevation reverted to normal after the surgery.

Keywords: ST-Segment elevation, acute abdomen, gastric perforation

Article citation: Vutthikraivit W. Perforated gastric ulcer with ST-segment elevation mimicking acute myocardial infarction. The Southwest Respiratory and Critical Care Chronicles 2020;8(33):56–59

From: Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas

Submitted: 12/9/2019

Accepted: 1/12/2020

Reviewer: Scott Shurmur MD

Conflicts of interest: none

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