Background: Chest pain is a frequent symptom of acute myocardial infarction, but the cause is not always coronary atherothrombosis. We present a case where the patient himself had made a correct non-cardiac diagnosis, but this was initially overlooked by the doctor.
Case Presentation: A man with a history of cardiac infarction was admitted with acute chest pain and troponin elevation. Electrocardiogram suggested ST elevations, echocardiography showed a possible slight hypokinesia, and we primarily suspected an acute coronary syndrome. However, invasive coronary angiography was negative and a primary acute myocardial infarction was less likely. A renewed interview revealed that the patient had worked with a propane burner indoors without adequate ventilation. The patient himself suspected carbon monoxide poisoning. Arterial blood gas showed HbCO 27.4 %, which was unfortunately overlooked initially. The patient had carbon monoxide poisoning with symptoms of dizziness, hand ataxia and myocardial ischaemia. He received 100 % oxygen and HbCO was normalised.
Interpretation: The imbalance between oxygen demand and supply resulted in a type 2 cardiac infarction. A thorough medical history is crucial for correct diagnosis but can unfortunately be missed on a busy shift. This case illustrates the importance of the patient's own diagnostic assumption.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.4045/tidsskr.23.0113 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
ECG Patterns of Occlusion Myocardial Infarction: A Narrative Review.
Ann Emerg Med
January 2025
Department of Emergency Medicine, University of Minnesota, Minneapolis, MN; Department of Emergency Medicine, Hennepin Healthcare, Minneapolis, MN.
The traditional management of acute coronary syndrome has relied on the identification of ST-segment elevation myocardial infarction (STEMI) as a proxy of acute coronary occlusion. This conflation of STEMI with acute coronary occlusion has historically overshadowed non-ST-segment elevation myocardial infarction (NSTEMI), despite evidence suggesting 25% to 34% of NSTEMI cases may also include acute coronary occlusion. Current limitations in the STEMI/NSTEMI binary framework underscore the need for a revised approach to chest pain and acute coronary syndrome management.
View Article and Find Full Text PDFPrognostic Value of D-Dimer in Acute Type A Aortic Dissection and Intramural Hematoma: Observations from the Acute Aortic Syndrome Group of the Registry of Acute Non-Traumatic Chest Pain in China.
J Am Heart Assoc
January 2025
Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, and The Key Laboratory of Cardiovascular Remodeling-related Diseases, Ministry of Education, and Beijing Institute of Heart Lung and Blood Vessel Disease Beijing China.
Background: Acute type A aortic dissection (AAD) and acute type A intramural hematoma (AIMH) are life-threatening conditions with high mortality rates, and prognostic indicators are critical for guiding urgent treatment decisions. We assessed the prognostic significance of admission D-dimer levels in patients with AAD and AIMH.
Methods And Results: The prospective, multicenter, observational study in China recruited participants from 2013 to 2019.
Role of bilevel erector spinae with high thoracic block vs conventional unilevel block in analgesia and reduction of pain in axilla in breast cancer surgeries: a randomized controlled trial.
Pain Rep
February 2025
Department of Anaesthesia, Surgical Critical Care and Pain Management, National Cancer Institute-Cairo University, Cairo, Egypt.
Introduction: Management of pain associated with breast cancer surgeries is crucial in reducing incidence of postmastectomy pain syndrome. The pain distribution involves the anterior chest wall, axillary area and ipsilateral upper limb.
Objective: This study was designed to investigate the effect of bilevel erector spinae plane block (ESPB) with high thoracic block vs the conventional unilevel ESPB vs opioids in patients with cancer undergoing modified radical mastectomy regarding pain control and reducing pain in axilla.
Pulmonary artery choriocarcinoma mimicking pulmonary thromboembolism: a case report.
Transl Cancer Res
December 2024
Department of Geriatric Respiratory Disease, Institute of Guangdong Provincial Geriatrics, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
Background: Primary choriocarcinoma of the pulmonary artery is an exceedingly rare malignant neoplasm, which is often misdiagnosed due to its nonspecific clinical presentation. While this condition is characterized by the presence of trophoblastic cells, typically associated with gestational trophoblastic diseases, we encountered a case occurring in an extragenital location. The rarity of such tumors makes it challenging for clinicians to consider them in differential diagnosis, especially when the initial symptoms mimic more common conditions such as pulmonary thromboembolism (PTE).
View Article and Find Full Text PDFPregnancy-Related Spontaneous Coronary Artery Dissection in a 25-Year-Old Woman: A Case Report.
Sisli Etfal Hastan Tip Bul
December 2024
Department of Cardiovascular Surgery, Basaksehir Cam and Sakura City Hospital, Istanbul, Türkiye.
Pregnancy-related spontaneous coronary artery dissection (P-SCAD) is a life-threatening condition that occurs during or after pregnancy, is rare and can be overlooked. It is one of the most important causes of pregnancy-related acute myocardial infarction. A 25-year-old female patient was admitted with a complaint of chest pain in her 37th week of pregnancy.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!