Spontaneous left pneumothorax can cause ECG changes mimicking anterior myocardial infarction when taken in the supine position, which resolve after correction.
May warrant considering pneumothorax in supine ECGs mimicking anterior MI; case report leaves open broader validation.
Keller N, Szaff M, Sykulski R (Department of Internal Medicine, Sundby Hospital, Copenhagen, Denmark). Electrocardiographic changes in spontaneous left pneumothorax. Acta Med Scand 1987; 221:499–501. A 25‐year‐old man was admitted with severe chest pain and an electrocardiogram suggestive of anterior myocardial infarction. Echocardiogram was normal, but chest X‐ray showed left‐sided pneumothorax. The electrocardiogram showed increasing R‐wave amplitude in the days after correction of pneumothorax. Taken in the supine position the electrocardiogram can be misleading in case of pneumothorax or mediastinal emphysema, but the electrocardiogram should be normal if taken in the erect position.
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Keller et al. (1987) studied this question.
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