Typical chest pain and precordial leads ST-elevation in patients with pacemakers - are we always looking at an acute myocardial infarction?
Introduction. Electrocardiographic (ECG) diagnosis of acute myocardial infarction (AMI) in patients with paced rhythm is difficult. Sgarbossa’s criteria represent helpful diagnostic ECG tool. Case report. A 57-year-old female patient with paroxysmal atrial fibrillation and a permanent pacem...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
2015-01-01
|
| Series: | Vojnosanitetski Pregled |
| Subjects: | |
| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2015/0042-84501500061O.pdf |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | Introduction. Electrocardiographic (ECG) diagnosis of acute myocardial
infarction (AMI) in patients with paced rhythm is difficult. Sgarbossa’s
criteria represent helpful diagnostic ECG tool. Case report. A 57-year-old
female patient with paroxysmal atrial fibrillation and a permanent pacemaker
presented in the Emergency Department with prolonged typical chest pain and
ECG recording suggestive for AMI. Documented ECG changes correspond to the
first Sgarbossa’s criterion for AMI in patients with dual pacemakers
(ST-segment elevation of ≥ 5 mm in the presence of the negative QRS complex).
The patient was sent to catheterization lab where coronary angiogram reveled
normal findings. ECG changes occurred due to pericardial reaction following
two interventions: pacemaker implantation a month before and radiofrequency
catheter ablation of AV junction two weeks before presentation in Emergency
Department. Conclusion. This case report points out to the limitations of
proposed criteria that aid in the recognition of AMI in patients with
underlying paced rhythm and possible cause(s) of transient
electrocardiographic abnormalities. |
|---|---|
| ISSN: | 0042-8450 2406-0720 |