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Case Report: Pancreatitis Mimics STEMI

By Bryan Knoedler, MD; Alex Koo, MD, FACEP; Max Hockstein, MD, FACEP | on December 11, 2023 | 2 Comments
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Dr. Knoedler is a resident physician at Georgetown University Hospital & Washington Hospital Center.

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ACEP Now: Vol 42 – No 12 – December 2023

Dr. Koo is an attending physician and assistant professor in emergency medicine on staff at MedStar St Mary’s Hospital and Medstar Washington Hospital Center.

Dr. Hockstein is an attending physician in emergency medicine and critical care medicine and is on staff at Medstar Georgetown University Hospital.

References

  1. Velez L, Hockstein M, Furmaga J, et al. Mimics of ST elevation myocardial infarction (STEMI). Emergency Medicine Reports website.Published June 1, 2016. Accessed November 29, 2023.
  2. Yu ES, Lange JJ, Broor A, et al. Acute pancreatitis masquerading as inferior wall myocardial infarction: a review. Case Rep Gastroenterol. 2019;13(2):321-35.
  3. Yegneswaran B, Kostis JB, Pitchumoni CS. Cardiovascular manifestations of acute pancreatitis. Journal of Critical Care. 2011;26(2):225.e11-225. e18.
  4. Khan U, Petrechko O, Sagheer S, et al. Acute pancreatitis and myocardial infarction: a narrative review. Cardiology. 2023;148(1):1-11.
  5. Hsu PC, Lin TH, Su HM, et al. Acute necrotizing pancreatitis complicated with ST elevation acute myocardial infarction: a case report and literature review. Kaohsiung J Med Sci. 2010;26(4):200-5.
  6. Phadke M, Punjabi P, Sharma S, et al. Acute pancreatitis complicated by ST-elevation myocardial infarction. J Emerg Med. 2013;44(5):932-935.
  7. Wägner A, Santaló M. A correct decision? Lancet. 2002;359(9301):157.
  8. Cafri C, Basok A, Katz A, et al. Thrombolytic therapy in acute pancreatitis presenting as acute myocardial infarction. Int J Cardiol. 1995;49(3):279-281.
  9. Wu CH, Wang KL, Lu TM. Perplexing epigastric pain-coincident myocardial infarction and acute pancreatitis. Intern Med. 2010;49(2):149-153.
  10. Sanghvi S, Waqar F, Effat M. Coronary thrombosis in acute pancreatitis. J Thromb Thrombolysis. 2019;47(1):157-161.
  11. Neupane P, Seedat Z, Moghareh M, et al. Pancreatitis-induced acute ST segment elevation and regional wall motion abnormality. Chest. 2020;158(4):A199.

Pages: 1 2 3 | Single Page

Topics: Acute Coronary SyndromeCase ReportsClinicalCritical CarepancreatitisSTEMI

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2 Responses to “Case Report: Pancreatitis Mimics STEMI”

  1. December 31, 2023

    Steven V Reply

    Awesome work! very important to be aware of mimics in this field.

  2. December 24, 2025

    James Reply

    The first EKG shows a limb lead reversal (LA/RA). Lead I is upside down. Leads II and III switch places, and leads aVL and aVR switch places. This is why there appears to be ST elevation in I and aVL. I’m surprised that no one recognized this.

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