A rare cause of chest pain mimicking myocardial infarction

• Published in: Türk Kardiyoloji Derneği arşivi Vol. 42; no. 5; pp. 472 - 474
• Main Authors: Keskin, Kudret, Başkurt, Murat, Aktürk, Faruk, Conkbayır, Cenk
• Format: Journal Article
• Language: English
• Published: Turkey KARE Publishing 01.07.2014
• Subjects: Chest Pain - etiology; cholangiopancreatography; Cholangiopancreatography, Endoscopic Retrograde - adverse effects; Coronary Angiography; Diagnosis, Differential; endoscopic retrograde; Female; Gallstones - surgery; Humans; Middle Aged; Myocardial Infarction - diagnosis; Myocardial Infarction - diagnostic imaging; myocardial infarction; pneumothorax; pneumomediastinum; Pneumothorax - diagnosis; Pneumothorax - diagnostic imaging; Pneumothorax - etiology; Postoperative Complications - diagnosis; Postoperative Complications - diagnostic imaging; Postoperative Complications - etiology; Tomography, X-Ray Computed
• ISSN: 1016-5169; 1016-5169
• DOI: 10.5543/tkda.2014.27163

We present a patient who underwent endoscopic retrograde cholangiopancreatography procedure for bile duct stone removal and sphincterotomy. Upon completion of the procedure, the patient experienced severe chest pain. Because myocardial infarction was the likely diagnosis, we immediately performed a coronary angiography, which identified severe coronary lesions without any total occlusion. Being skeptical of the possible cause, we searched for alternative causes and interestingly found pneumothorax, pneumomediastinum, and retro-intra-abdominal free air. This rare complication is particularly important for a cardiologist because they should be aware of such a complication, and correlation with the symptoms and coronary lesions should always be made.