Abstract
BackgroundAcute cholecystitis sometimes displays symptoms and electrocardiographic changes mimicking cardiovascular problems. It may also coexist with cardiovascular disorders. We analyzed the clinical characteristic of the cardiac patients who were diagnosed with acute cholecystitis during hospitalization in the cardiology department.MethodsUsing the department database, we identified 16 patients who were diagnosed with acute cholecystitis during the hospitalization in the cardiology department between June 2010 and June 2014.ResultsFive patients who were initially suspected to have cardiac problems (acute coronary syndrome, four patients; Adams-Stokes syndrome, one patient) owing to their symptoms were subsequently diagnosed with acute cholecystitis. Two of these patients showed electrocardiographic changes mimicking myocardial ischemia, and three tested positive for a biomarker (heart-type fatty acid binding protein) of acute myocardial injury. The 11 remaining cardiac patients were diagnosed with acute cholecystitis during their hospitalization or at the time of admission. Prolonged fasting and/or staying in an intensive care unit (ICU) may have contributed to their condition. Among these 11 patients, aortic dissection was the most prevalent underlying cardiac condition, affecting 5 patients.ConclusionsAlthough it is a rare condition, acute cholecystitis may coexist with or be misdiagnosed as a cardiovascular disorder. This possibility should not be overlooked in cardiac patients because a delay in treatment may result in critical complications.
Highlights
Acute cholecystitis sometimes displays symptoms and electrocardiographic changes mimicking cardiovascular problems
We identified 18 patients who were diagnosed with acute cholecystitis during their hospitalization in the cardiology department
Of these 18 patients, 2 patients did not have symptoms suggestive of de novo occurrence or worsening of cardiovascular conditions. After excluding these two patients, the remaining 16 patients were divided into two groups as follows: group 1 included 5 patients who were initially diagnosed with cardiac conditions, and in whom the signs and symptoms were due to cholecystitis; group 2 included 11 patients who were admitted with a cardiac condition and cholecystitis developed during their hospitalization or coexisted at the time of admission
Summary
Acute cholecystitis sometimes displays symptoms and electrocardiographic changes mimicking cardiovascular problems. We analyzed the clinical characteristic of the cardiac patients who were diagnosed with acute cholecystitis during hospitalization in the cardiology department. Due to the similarity of symptoms, it is sometimes difficult to make a differential diagnosis between a biliary system disease, such as acute cholecystitis, and cardiovascular disorders [1,2,3]. The exact mechanisms are poorly understood, laboratory data mimicking cardiovascular disease, such as elevation of cardiac troponin [4] and changes in electrocardiogram (ECG) data suggestive of ischemic heart disease [1, 5], may
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