Catheter-directed thrombolysis successfully relieved chest tightness and resolved ECG abnormalities in a man in his early 70s with acute pulmonary embolism mimicking STEMI.
Case Report (n=1)
Acute pulmonary embolism can rarely present with ST-segment elevation and elevated troponin mimicking acute myocardial infarction, highlighting the need for clinical suspicion and risk stratification.
Acute pulmonary embolism (APE) with ST-segment elevation and an upward T-wave is rare, and only a few cases have been reported to date. We herein present a case involving a man in his early 70s with an 8-hour history of dyspnea. Serial electrocardiography (ECG) demonstrated ST-segment elevation in leads V1 to V3 with an upward T-wave, laboratory tests revealed a high serum concentration of high-sensitivity cardiac troponin I, and signs of acute myocardial infarction were present. However, emergency coronary angiography revealed normal coronary arteries. A subsequent computed tomography scan of the pulmonary arteries showed findings consistent with APE. The patient's chest tightness was relieved after catheter-directed thrombolysis. Postoperative ECG showed that the ST-segment in leads V1 to V3 had fallen back and that the T-wave was inverted. The patient was discharged on rivaroxaban therapy. Clinically, the ECG findings of ST-segment elevation and an upward T-wave in APE can be easily misdiagnosed as acute myocardial infarction. Physicians should maintain clinical suspicion through risk stratification to identify APE.
Yue et al. (Fri,) conducted a case report in Acute pulmonary embolism (n=1). Catheter-directed thrombolysis was evaluated on Symptom relief and ECG resolution. Catheter-directed thrombolysis successfully relieved chest tightness and resolved ECG abnormalities in a man in his early 70s with acute pulmonary embolism mimicking STEMI.