Minimal pneumothorax with dynamic changes in ST segment similar to myocardial infarction

Am J Emerg Med. 2017 Aug;35(8):1210.e1-1210.e4. doi: 10.1016/j.ajem.2017.04.037. Epub 2017 Apr 19.

Abstract

Pneumothorax can cause a variety of electrocardiographic changes. ST segment elevation, which is mainly observed in myocardial infarction, can also be induced by pneumothorax. The mechanism is presumed to be a decrease in cardiac output, due to increased intra-thoracic pressure. We encountered a patient with ST segment elevation with minimal pneumothorax. Coronary angiography with ergonovine provocation test and echocardiogram had normal findings. The ST segment elevation was normalized by decreasing the amount of pneumothorax. We reviewed the literature and present possible mechanisms for this condition.

Keywords: Electrocardiography; Pneumothorax; ST segment elevation; T wave inversion.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Chest Pain
  • Electrocardiography*
  • Humans
  • Male
  • Pneumothorax / complications
  • Pneumothorax / diagnostic imaging
  • Pneumothorax / physiopathology*
  • Radiography, Thoracic / methods*
  • ST Elevation Myocardial Infarction / diagnostic imaging
  • ST Elevation Myocardial Infarction / etiology
  • ST Elevation Myocardial Infarction / physiopathology*
  • Treatment Outcome