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Challenges in Clinical Electrocardiography
September 13, 2021

ST-Segment Elevation Myocardial Infarction Mimic: Unearthing the Hidden Truth

Author Affiliations
  • 1Department of Cardiology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning Province, China
JAMA Intern Med. 2021;181(11):1509-1510. doi:10.1001/jamainternmed.2021.4427

A woman in her 60s with a history of hypertension presented to the emergency department with sudden-onset chest pain. She had no history of any acute febrile illness or family history of sudden cardiac death. She was tachycardic with a pulse of 120 beats/min. Her blood pressure was normal. Her white blood cell count was 14 300/µL (normal range: 3500-9500/µL; to convert to ×109/L, multiply by 0.001), while the serum calcium concentration was within the normal limits. High-sensitivity troponin I level was 1.15 ng/mL (normal range: <0.015 ng/mL; to convert to μg/L, multiply by 1.0), and the brain-type natriuretic peptide level was 1060.30 pg/mL (normal range: 0-100 pg/mL; to convert to ng/L, multiply by 1.0). Her admission electrocardiogram (ECG) is shown in the Figure, A.

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