| Pancreatic cholangiocarcinoma as an ST-elevation myocardial infarction with thrombolytic therapy. | |
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MedLine Citation:
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PMID: 20223412 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We report the case of a 46-year-old patient who presented a chest pain with ST-segment elevation in precordial leads V1 (2 mm), V2 (4 mm), and V3 (3 mm). Thrombolytic therapy was initiated with the combination tenecteplase tissue plasminogene activator, aspirin, and heparin. Further electrocardiogram and cardiac enzymes measured every 2 hours during the first 24 hours remained normal, and after a computed tomography of the abdomen, the patient was taken to surgery for an exploratory abdominal operation that revealed pancreatic cholangiocarcinoma. No adverse effects were attributed to the initial thrombolytic therapy. Finally, myocardial ischemia was excluded because the electrocardiogram, cardiac enzymes, and a 1-month later cardiac stress test remained normal and because no coronary event occurred during the first year after surgery. Our case shows that it is sometimes difficult to make the share, in prehospital field, between coronary syndrome and other pathology, particularly digestive pathology. However, in the appropriate chest pain patient with presumed acute myocardial infarction, ST-segment elevation remains the primary criterion for the initiation of thrombolytic therapy, primary angioplasty, and/or other pharmacologic interventions. |
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Authors:
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Baptiste Vallé; Philippe Frontin; Vincent Bounes; Sandrine Charpentier; Charpentier Sandrine; Vincent Minville; Jean-Louis Ducassé; Ducassé Jean-Louis |
Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: The American journal of emergency medicine Volume: 28 ISSN: 1532-8171 ISO Abbreviation: Am J Emerg Med Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-03-12 Completed Date: 2010-05-06 Revised Date: 2010-10-12 |
Medline Journal Info:
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Nlm Unique ID: 8309942 Medline TA: Am J Emerg Med Country: United States |
Other Details:
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Languages: eng Pagination: 389.e3-5 Citation Subset: IM |
Affiliation:
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SAMU, Pôle de Medecine d'Urgence, Hôpitaux Universitaires, Toulouse, France. baptistevalle@aol.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Chest Pain
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drug therapy,
radiography Cholangiocarcinoma / radiography*, surgery Diagnosis, Differential Electrocardiography Humans Male Middle Aged Myocardial Infarction / diagnosis, drug therapy Pancreatic Neoplasms / radiography*, surgery Thrombolytic Therapy Tomography, X-Ray Computed |
| Comments/Corrections | |
Erratum In:
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Am J Emerg Med. 2010 Oct;28(8):980 Note: Sandrine, Charpentier [corrected to Charpentier, Sandrine];Jean-Louis, Ducassé [corrected to Ducassé, Jean-Louis] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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