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Am J Med Sci. 2012 Dec;344(6):499-500. doi: 10.1097/MAJ.0b013e318259b86b.

Pseudomyocardial infarction caused by expansion of colonic tube used for esophageal reconstruction.

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Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, China.


Electrocardiography (ECG) is a useful tool for detecting ischemic heart disease. However, it has been pointed out that those ECG abnormalities resembling myocardial ischemia may be induced by extracardiac factors. We describe a 44-year-old man in whom a colonic tube was used for esophageal reconstruction via the anterior mediastinum after esophagectomy and gastrectomy for gastrointestinal corrosive injury. The reconstructive tube filled with gas resulted in compression of the heart and caused angina-like chest pain associated with ST-segment elevation in lead II, III and aVF on the ECG. Coronary angiography revealed no stenosis of arteries. Decompression of the colonic tube by the nasogastric tube resulted in normalization of the ECG.

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