Case Report

Reversible ST-segment Elevation Associated with Atelectasis of the Left Lung

Authors: Matt Sampson, BS, C Edward Rose, Jr, MD

Abstract

A 22-year-old male with cerebral palsy and respiratory failure had acute reversible ST-segment elevation in the inferior leads during acute collapse of the left lung, which resolved with re-expansion of the left lung several hours later. This suggests that major lung actelectasis needs to be added to the group of noncardiac conditions considered when evaluating ST elevation in the critically ill patient.


Key Points


* ST-segment elevation is an important finding that can lead to the early detection of myocardial ischemia and infarction.


* A number of nonischemic cardiac and noncardiac problems can be associated with ST-segment elevation.


* Complete atelectasis of the left lung is an additional problem that can lead to ST-segment elevation.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Wang K, Asinger RW, Marriott HJ. ST-segment elevation in conditions other than acute myocardial infarction. N Engl J Med 2003;349:2128–2135.
 
2. Kounis NG, Zavras GM, Kitrou MP, et al. Unusual electrocardiographic manifestations in conditions with increased intrathoracic pressure. Acta Cardiol 1988;43:653–661.
 
3. Goddard R, Scofield RH. Right pneumothorax with the S1Q3T3 electrocardiogram pattern usually associated with pulmonary embolus. Am J Emerg Med 1997;15:310–312.
 
4. Slay RD, Slay LE, Luehrs JG. Transient ST elevation associated with tension pneumothorax. JACEP1979;8:16–18.
 
5. Kuritzky P, Goldfarb AL. Unusual electrocardiographic changes in spontaneous pneumothorax. Chest1976;70:535–537.
 
6. Janssens U, Koch KC, Graf J, et al. Severe transmyocardial ischemia in a patient with tension pneumothorax. Crit Care Med 2000;28:1638–1641.