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ST elevation in a patient with small bowel occlusion and gastricdistension—What is the most likely explanation? A hypothesisgenerating case report

Lookup NU author(s): David Richley


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© 2019 Elsevier Inc.We report a case of ST segment elevation and PR depression in inferolateral leads in a patient with small bowel occlusion and gastric distension that disappeared immediately after gastric evacuation. Contrary to prior reports, we believe that these ECG changes do not represent an intrinsic cardiac electrical abnormality, but are likely artefactual. We hypothesise that the accumulated air between the heart, lower limbs and left precordial electrodes result in a significant departure from the simplified assumptions of standard 12 lead ECG analysis (that the electrical activity of the heart can be described by an electrical dipole at a fixed location in an electrical homogeneous sphere) in such a way that the ECG filtering process will not compensate for this bias and will artificially create the ECG pattern described in this report.

Publication metadata

Author(s): Margulescu AD, Rees E, Richley D, Thomas DE, Smith D

Publication type: Article

Publication status: Published

Journal: Journal of Electrocardiology

Year: 2019

Volume: 57

Pages: 77-80

Print publication date: 01/11/2019

Online publication date: 28/08/2019

Acceptance date: 02/04/2016

ISSN (print): 0022-0736

ISSN (electronic): 1532-8430

Publisher: Elsevier


DOI: 10.1016/j.jelectrocard.2019.08.044


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