Abstract
Acute pancreatitis can be associated with electrical changes mimicking acute coronary syndrome with normal coronary arteries. The association of acute pancreatitis with ST-segment elevation and elevated cardiac enzymes has been reported in few observations. The pathophysiological mechanisms of this association remain poorly understood.We report the case of a 63-year-old woman presenting with chest pain, changes in the electrocardiogram and elevated cardiac enzymes with normal coronary arteries associated with acute pancreatitis. Stress cardiomyopathy or Takotsubo syndrome associated with acute pancreatitis was the most likely diagnosis in our case. Stress cardiomyopathy should be considered a possibility in case of patients with acute pancreatitis who present with clinical signs suggestive of acute coronary syndrome.
Highlights
Acute pancreatitis is an acute inflammatory process of the pancreas clinically characterized by epigastralgia, accompanied by elevated pancreatic enzymes [1]
The association of acute pancreatitis with ST segment elevation has been reported in few observations and many pathophysiological mechanisms were incriminated such as coronary spasm and hydroelectrolytic disorders [3]
Patel et al described in 1994 the association of transient regional wall-motion abnormality and normal epicardial coronary arteries with segment ST elevation during acute pancreatitis; they linked it to vagal stimulation [10]
Summary
Acute pancreatitis is an acute inflammatory process of the pancreas clinically characterized by epigastralgia, accompanied by elevated pancreatic enzymes [1]. We report the case of a patient presenting with chest pain, changes in the electrocardiogram and elevated cardiac enzymes with normal coronary arteries concurrently with acute pancreatitis. Through this observation and based on literature data, we will highlight the possible explanations for this association which may have stress cardiomyopathy as a physiopathological basis. Due to increased epigastric pain, an ECG was performed showing regression of ST segment elevation without pathologic Q waves or negative T waves in the posterior leads (Figure 2).
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
