Skip to main content
main-content
Top

Tip

Swipe om te navigeren naar een ander artikel

Gepubliceerd in: Netherlands Heart Journal 10/2008

01-10-2008 | original article

Conditions mimicking acute ST-segment elevation myocardial infarction in patients referred for primary percutaneous coronary intervention

Auteurs: Y. L. Gu, T. Svilaas, I. C. C. van der Horst, F. Zijlstra

Gepubliceerd in: Netherlands Heart Journal | Uitgave 10/2008

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Abstract

Background/Objectives. A rapid diagnosis of ST-segment elevation myocardial infarction (STEMI) is mandatory for optimal treatment. However, a small proportion of patients with suspected STEMI suffer from other conditions. Although case reports have described these conditions, a contemporary systematic analysis is lacking. We report the incidence, clinical characteristics and outcome of patients with suspected STEMI referred for primary percutaneous coronary intervention (PCI) with a final diagnosis other than STEMI.
Methods. From January 2004 to July 2005, 820 consecutive patients were included with suspected STEMI who were referred for primary PCI to a university medical centre, based on a predefined protocol. Clinical characteristics, final diagnosis and outcome were obtained from patient charts and databases.
Results. In 19 patients (2.3%), a final diagnosis other than myocardial infarction was established: coronary aneurysm (n=1), (myo)pericarditis (n=5), cardiomyopathy (n=2), Brugada syndrome (n=1), aortic stenosis (n=1), aortic dissection (n=3), subarachnoidal haemorrhage (n=2), pneumonia (n=1), chronic obstructive pulmonary disease (n=1), mediastinal tumour (n=1), and peritonitis after recent abdominal surgery (n=1). These patients less often reported previous symptoms of angina (p<0.001), smoking (p<0.05) and a positive family history of cardiovascular diseases (p<0.05) than STEMI patients. Mortality at 30 days was 16%.
Conclusion. A 2.3% incidence of conditions mimicking STEMI was found in patients referred for primary PCI. A high clinical suspicion of conditions mimicking STEMI remains necessary. (Neth Heart J 2008;16:325-31.)
Literatuur
1.
go back to reference Bradley EH, Herrin J, Wang Y, et al. Strategies for reducing the door-to-balloon time in acute myocardial infarction. N Engl J Med 2006; 355:2308-20. Bradley EH, Herrin J, Wang Y, et al. Strategies for reducing the door-to-balloon time in acute myocardial infarction. N Engl J Med 2006; 355:2308-20.
2.
go back to reference Brodie BR, Stuckey TD, Wall TC, et al. Importance of time to reperfusion for 30-day and late survival and recovery of left ventricular function after primary angioplasty for acute myocardial infarction. J Am Coll Cardiol 1998; 32:1312-9. Brodie BR, Stuckey TD, Wall TC, et al. Importance of time to reperfusion for 30-day and late survival and recovery of left ventricular function after primary angioplasty for acute myocardial infarction. J Am Coll Cardiol 1998; 32:1312-9.
3.
go back to reference Zijlstra F, Patel A, Jones M, et al. Clinical characteristics and outcome of patients with early (<2 h), intermediate (2-4 h) and late (>4 h) presentation treated by primary coronary angioplasty or thrombolytic therapy for acute myocardial infarction. Eur Heart J 2002; 23:550-7. Zijlstra F, Patel A, Jones M, et al. Clinical characteristics and outcome of patients with early (<2 h), intermediate (2-4 h) and late (>4 h) presentation treated by primary coronary angioplasty or thrombolytic therapy for acute myocardial infarction. Eur Heart J 2002; 23:550-7.
4.
go back to reference DeWood MA, Spores J, Notske R, et al. Prevalence of total coronary occlusion during the early hours of transmural myocardial infarction. N Engl J Med 1980; 303:897-902. DeWood MA, Spores J, Notske R, et al. Prevalence of total coronary occlusion during the early hours of transmural myocardial infarction. N Engl J Med 1980; 303:897-902.
5.
go back to reference Widimsky P, Stellova B, Groch L, et al. Prevalence of normal coronary angiography in the acute phase of suspected ST-elevation myocardial infarction: experience from the PRAGUE studies. Can J Cardiol 2006; 22:1147-52. Widimsky P, Stellova B, Groch L, et al. Prevalence of normal coronary angiography in the acute phase of suspected ST-elevation myocardial infarction: experience from the PRAGUE studies. Can J Cardiol 2006; 22:1147-52.
6.
go back to reference Da Costa A, Isaaz K, Faure E, Mourot S, Cerisier A, Lamaud M. Clinical characteristics, aetiological factors and long-term prognosis of myocardial infarction with an absolutely normal coronary angiogram; a 3-year follow-up study of 91 patients. Eur Heart J 2001; 22:1459-65. Da Costa A, Isaaz K, Faure E, Mourot S, Cerisier A, Lamaud M. Clinical characteristics, aetiological factors and long-term prognosis of myocardial infarction with an absolutely normal coronary angiogram; a 3-year follow-up study of 91 patients. Eur Heart J 2001; 22:1459-65.
7.
go back to reference Raymond R, Lynch J, Underwood D, Leatherman J, Razavi M. Myocardial infarction and normal coronary arteriography: a 10 year clinical and risk analysis of 74 patients. J Am Coll Cardiol 1988; 11:471-7. Raymond R, Lynch J, Underwood D, Leatherman J, Razavi M. Myocardial infarction and normal coronary arteriography: a 10 year clinical and risk analysis of 74 patients. J Am Coll Cardiol 1988; 11:471-7.
8.
go back to reference Wang K, Asinger RW, Marriott HJ. ST-segment elevation in conditions other than acute myocardial infarction. N Engl J Med. 2003; 349:2128-35. Wang K, Asinger RW, Marriott HJ. ST-segment elevation in conditions other than acute myocardial infarction. N Engl J Med. 2003; 349:2128-35.
9.
go back to reference Bertrand ME, Simoons ML, Fox KA, et al. Management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J 2002; 23:1809-40. Bertrand ME, Simoons ML, Fox KA, et al. Management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J 2002; 23:1809-40.
10.
go back to reference Angelini A, Calzolari V, Calabrese F, et al. Myocarditis mimicking acute myocardial infarction: role of endomyocardial biopsy in the differential diagnosis. Heart 2000; 84:245-50. Angelini A, Calzolari V, Calabrese F, et al. Myocarditis mimicking acute myocardial infarction: role of endomyocardial biopsy in the differential diagnosis. Heart 2000; 84:245-50.
11.
go back to reference Surawicz B, Lasseter KC. Electrocardiogram in pericarditis. Am J Cardiol 1970; 26:471-4. Surawicz B, Lasseter KC. Electrocardiogram in pericarditis. Am J Cardiol 1970; 26:471-4.
12.
go back to reference Livaditis IG, Paraschos M, Dimopoulos K. Massive pulmonary embolism with ST elevation in leads V1-V3 and successful thrombo-lysis with tenecteplase. Heart 2004; 90:e41. Livaditis IG, Paraschos M, Dimopoulos K. Massive pulmonary embolism with ST elevation in leads V1-V3 and successful thrombo-lysis with tenecteplase. Heart 2004; 90:e41.
13.
go back to reference Spittell PC, Spittell JA Jr, Joyce JW, et al. Clinical features and differential diagnosis of aortic dissection: experience with 236 cases (1980 through 1990). Mayo Clin Proc 1993; 68:642-51. Spittell PC, Spittell JA Jr, Joyce JW, et al. Clinical features and differential diagnosis of aortic dissection: experience with 236 cases (1980 through 1990). Mayo Clin Proc 1993; 68:642-51.
14.
go back to reference Ryan ET, Pak PH, DeSanctis RW. Myocardial infarction mimicked by acute cholecystitis. Ann Intern Med 1992; 116:218-20. Ryan ET, Pak PH, DeSanctis RW. Myocardial infarction mimicked by acute cholecystitis. Ann Intern Med 1992; 116:218-20.
15.
go back to reference Fulton MC, Marriott HJ. Acute pancreatitis simulating myocardial infarction in the electrocardiogram. Ann Intern Med 1963; 59: 730-2. Fulton MC, Marriott HJ. Acute pancreatitis simulating myocardial infarction in the electrocardiogram. Ann Intern Med 1963; 59: 730-2.
16.
go back to reference Bouten MJ, Simoons ML. Strategies for pre-hospital thrombo-lysis: an overview. Eur Heart J 1991;12 ( Suppl G):39-42. Bouten MJ, Simoons ML. Strategies for pre-hospital thrombo-lysis: an overview. Eur Heart J 1991;12 ( Suppl G):39-42.
17.
go back to reference Brugada P, Brugada J. Right bundle branch block, persistent ST segment elevation and sudden cardiac death: a distinct clinical and electrocardiographic syndrome. A multicenter report. J Am Coll Cardiol 1992; 20:1391-6. Brugada P, Brugada J. Right bundle branch block, persistent ST segment elevation and sudden cardiac death: a distinct clinical and electrocardiographic syndrome. A multicenter report. J Am Coll Cardiol 1992; 20:1391-6.
18.
go back to reference Elsman P, Alleman MA, Zijlstra F. [Clinical presentations mimicking acute myocardial infarction; therapeutic pitfalls]. Ned Tijd-schr Geneeskd 1998; 142:1057-60. Elsman P, Alleman MA, Zijlstra F. [Clinical presentations mimicking acute myocardial infarction; therapeutic pitfalls]. Ned Tijd-schr Geneeskd 1998; 142:1057-60.
19.
go back to reference Costantini M,Tritto C, Licci E, et al. Myocarditis with ST-Elevation Myocardial Infarction presentation in young man. A case series of 11 patients. Int J Cardiol 2005; 101:157-8. Costantini M,Tritto C, Licci E, et al. Myocarditis with ST-Elevation Myocardial Infarction presentation in young man. A case series of 11 patients. Int J Cardiol 2005; 101:157-8.
20.
go back to reference Ozeke O, Aras D, Deveci B, Yildiz A, Maden O, Selcuk MT. Brugada-like early repolarization pattern misdiagnosed as acute anterior myocardial infarction in a patient with myocardial bridging of the left anterior descending artery. Mt Sinai J Med 2006; 73: 627-30. Ozeke O, Aras D, Deveci B, Yildiz A, Maden O, Selcuk MT. Brugada-like early repolarization pattern misdiagnosed as acute anterior myocardial infarction in a patient with myocardial bridging of the left anterior descending artery. Mt Sinai J Med 2006; 73: 627-30.
21.
go back to reference Sajeev CG, Vinayakumar D, Venugopal K. Brugada syndrome simulating acute myocardial infarction. Int J Cardiol 2005; 99: 155-6. Sajeev CG, Vinayakumar D, Venugopal K. Brugada syndrome simulating acute myocardial infarction. Int J Cardiol 2005; 99: 155-6.
22.
go back to reference Antman EM, Braunwald E. ST-elevation myocardial infarction: pathology, pathophysiology, and clinical features. In: Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's heart disease: a textbook of cardiovascular medicine. Philadelphia, PA: Elsevier Saunders; 2005:1141-65. Antman EM, Braunwald E. ST-elevation myocardial infarction: pathology, pathophysiology, and clinical features. In: Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's heart disease: a textbook of cardiovascular medicine. Philadelphia, PA: Elsevier Saunders; 2005:1141-65.
23.
go back to reference Blankenship JC, Almquist AK. Cardiovascular complications of thrombolytic therapy in patients with a mistaken diagnosis of acute myocardial infarction. J Am Coll Cardiol 1989; 14:1579-82. Blankenship JC, Almquist AK. Cardiovascular complications of thrombolytic therapy in patients with a mistaken diagnosis of acute myocardial infarction. J Am Coll Cardiol 1989; 14:1579-82.
24.
go back to reference Kahn JK. Inadvertent thrombolytic therapy for cardiovascular diseases masquerading as acute coronary thrombosis. Clin Cardiol 1993; 16:67-71. Kahn JK. Inadvertent thrombolytic therapy for cardiovascular diseases masquerading as acute coronary thrombosis. Clin Cardiol 1993; 16:67-71.
25.
go back to reference Gu YL, van den Heuvel AFM, Erasmus ME, Zijlstra F. Aortic dissection presenting as acute myocardial infarction: potential harm of antithrombin and antiplatelet therapy. Neth Heart J 2006; 14: 147-9. Gu YL, van den Heuvel AFM, Erasmus ME, Zijlstra F. Aortic dissection presenting as acute myocardial infarction: potential harm of antithrombin and antiplatelet therapy. Neth Heart J 2006; 14: 147-9.
26.
go back to reference Nakamura Y, Kaseno K, Kubo T. Transient ST-segment elevation in subarachnoid hemorrhage. J Electrocardiol 1989; 22:133-7. Nakamura Y, Kaseno K, Kubo T. Transient ST-segment elevation in subarachnoid hemorrhage. J Electrocardiol 1989; 22:133-7.
27.
go back to reference Lee TH, Cannon CP. Approach to the patient with chest pain. In: Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's heart disease: a textbook of cardiovascular medicine. Philadelphia, PA: Elsevier Saunders; 2005:1129-39. Lee TH, Cannon CP. Approach to the patient with chest pain. In: Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's heart disease: a textbook of cardiovascular medicine. Philadelphia, PA: Elsevier Saunders; 2005:1129-39.
28.
go back to reference Chapman GD, Ohman EM, Topol EJ, et al. Minimizing the risk of inappropriately administering thrombolytic therapy (Thrombolysis and Angioplasty in Myocardial Infarction [TAMI] study group). Am J Cardiol 1993; 71:783-7. Chapman GD, Ohman EM, Topol EJ, et al. Minimizing the risk of inappropriately administering thrombolytic therapy (Thrombolysis and Angioplasty in Myocardial Infarction [TAMI] study group). Am J Cardiol 1993; 71:783-7.
29.
go back to reference Khoury NE, Borzak S, Gokli A, Havstad SL, Smith ST, Jones M. “Inadvertent” thrombolytic administration in patients without myocardial infarction: clinical features and outcome. Ann Emerg Med 1996; 28:289-93. Khoury NE, Borzak S, Gokli A, Havstad SL, Smith ST, Jones M. “Inadvertent” thrombolytic administration in patients without myocardial infarction: clinical features and outcome. Ann Emerg Med 1996; 28:289-93.
30.
go back to reference Terkelsen CJ, Lassen JF, Norgaard BL, et al. Reduction of treatment delay in patients with ST-elevation myocardial infarction: impact of pre-hospital diagnosis and direct referral to primary percutaneous coronary intervention. Eur Heart J 2005; 26:770-7. Terkelsen CJ, Lassen JF, Norgaard BL, et al. Reduction of treatment delay in patients with ST-elevation myocardial infarction: impact of pre-hospital diagnosis and direct referral to primary percutaneous coronary intervention. Eur Heart J 2005; 26:770-7.
31.
go back to reference Larson DM, Menssen KM, Johnson RK, et al. False positive ST elevation in patients undergoing direct percutaneous coronary intervention. Circulation 2006; 114:II-346. Larson DM, Menssen KM, Johnson RK, et al. False positive ST elevation in patients undergoing direct percutaneous coronary intervention. Circulation 2006; 114:II-346.
32.
go back to reference van 't Hof AW, Rasoul S, van de Wetering H, et al. Feasibility and benefit of prehospital diagnosis, triage, and therapy by paramedics only in patients who are candidates for primary angioplasty for acute myocardial infarction. Am Heart J 2006; 151:1255-5.e5. van 't Hof AW, Rasoul S, van de Wetering H, et al. Feasibility and benefit of prehospital diagnosis, triage, and therapy by paramedics only in patients who are candidates for primary angioplasty for acute myocardial infarction. Am Heart J 2006; 151:1255-5.e5.
Metagegevens
Titel
Conditions mimicking acute ST-segment elevation myocardial infarction in patients referred for primary percutaneous coronary intervention
Auteurs
Y. L. Gu
T. Svilaas
I. C. C. van der Horst
F. Zijlstra
Publicatiedatum
01-10-2008
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Netherlands Heart Journal / Uitgave 10/2008
Print ISSN: 1568-5888
Elektronisch ISSN: 1876-6250
DOI
https://doi.org/10.1007/BF03086173

Andere artikelen Uitgave 10/2008

Netherlands Heart Journal 10/2008 Naar de uitgave