PDF(Pubmed)
Abstract：
Acute abdominal pathologies can cause electrocardiogram (ECG) changes mimicking an acute coronary syndrome (ACS), resulting in diagnostic uncertainty and delay. We report a 65-year-old male with multiple risk factors for ACS who presented with four hours of progressive epigastric and chest pain that resolved in the emergency department. ECG findings were concerning for new deeply inverted T-waves with normal troponins, raising concerns for Wellens Syndrome. Emergent heart catheterization was negative but abdominal computed tomography angiography showed occlusion of the superior mesenteric vessels. Subsequent exploratory laparotomy revealed a small bowel volvulus with extensive necrosis, resulting in a 430 cm resection.
摘要：
急性腹部病变可引起模拟急性冠脉综合征（ACS）的心电图（ECG）变化，导致诊断的不确定性和延迟。我们报告了一名65岁的男性，患有ACS的多种危险因素，他表现为四个小时的进行性上腹部和胸痛，在急诊科得以解决。心电图的发现是关于新的深度倒置T波与正常的肌钙蛋白，引起对Wellens综合症的关注。紧急心导管检查阴性，但腹部计算机断层扫描血管造影显示肠系膜上血管闭塞。随后的剖腹探查术显示小肠扭转伴广泛坏死，导致430厘米切除。
