IMR Press / JMCM / Volume 3 / Issue 3 / DOI: 10.31083/j.jmcm.2020.03.826
Open Access Case Report
Cardiac extrinsic compression due to abdominal distension as a cause of electrocardiographic abnormality in a critically ill patient
Show Less
1 Cardiology department, Hospital Clínico Universitario “Lozano Blesa”, Zaragoza, Spain
2 Radiology department, Hospital Clínico Universitario “Lozano Blesa”, Zaragoza, Spain
juanma_cheick@hotmail.com (Juan Manuel Salvador-Casabón)
J. Mol. Clin. Med. 2020, 3(3), 87–90; https://doi.org/10.31083/j.jmcm.2020.03.826
Submitted: 26 August 2020 | Accepted: 12 September 2020 | Published: 30 September 2020
Abstract

Anomalies in the ST segment, especially ST-segment elevation, require the ruling out of possible etiologies such as myocardial ischemia or pericarditis. However, other non-cardiac disorders such as increases in intra-abdominal and intrathoracic pressure, may cause ST-segment elevation as well and should be considered as possible etiologies due to the poor prognosis they imply in the clinical evolution of the patient. This is especially important in critically ill patients. In this respect, we herein present a case in which the increase in intra-abdominal pressure and thoracic cavity elevation due to gastric and intestinal distension, which was not present in the first CT, provoked a cardiac and coronary compression resulting in T-shaped dome wave, a QT prolongation and ST segment elevation in the inferior leads of the electrocardiogram, the patient did not present at the time of admission, ruling out other possible etiologies such as ionic imbalance or acute ischemia.

Keywords
Abnormal electrocardiogram
ST segment elevation
QT prolongation
Spiked Helmet sign
abdominal distension
Figures
Fig. 1.
Share
Back to top