Key result
Acute alcohol intoxication in a 19-year-old male caused widespread ST-segment elevation mimicking acute coronary syndrome, which resolved upon normalization of blood alcohol levels.
Why the study?
ST-segment elevation in the emergency department represents a potentially life-threatening condition, but the literature is poor regarding widespread ST-segment elevation and coronary spasm induced by acute alcohol ingestion.
Case Report (n=1)
Acute alcohol intoxication can induce significant ST-segment elevation mimicking acute coronary syndrome, likely due to coronary vasospasm, which resolves upon alcohol clearance.
May prompt consideration of alcohol intoxication in young patients with ST elevation; leaves open prevalence and mechanisms of this mimic.
A patient presenting an ST-segment elevation could represent a life-threatening condition in Emergency Department (ED). This case shows how sometimes, a chronic, and more often, an acute abuse of alcohol is related to important harmful effects on myocardial contractility. The authors present a case of a 19-year-old male of oriental-Asiatic origin admitted unconscious to ED with alcoholic fetor: on electrocardiogram a significant and widespread STsegment elevation was observed. A bedside echocardiography showed no abnormalities in segmental kinetics; therefore electrocardiogram- alterations could be related to a coronary spasm. The literature is poor about this effect induced by acute alcohol ingestion: the pathophysiological mechanism at the base of the abnormal muscle contractility, seems to be related to an impairment in cyclic guanosine monophosphate production, although a second and less probable hypothesis could be an altered intracellular concentration of calcium levels.
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Lai et al. (2020) conducted a case report in Acute alcohol intoxication mimicking acute coronary syndrome (n=1). Acute alcohol intoxication was evaluated on Electrocardiographic ST-segment elevation. Acute alcohol intoxication in a 19-year-old male caused widespread ST-segment elevation mimicking acute coronary syndrome, which resolved upon normalization of blood alcohol levels.
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