Abstract
Differential diagnosis between acute myocardial infarction (AMI) and an acute surgical abdomen can be difficult. Although the electrocardiogram (ECG) is the most valuable immediate tool in this differential diagnosis, it is crucial to be aware of certain limitations of the ECG under these circumstances. This report describes a patient presenting with electrocardiographic changes consistent with a Q-wave AMI, a perforated duodenal ulcer, and no evidence of AMI or significant coronary artery narrowing at necropsy.
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