Chest
Clinical InvestigationsAcute and Transient ST Segment Elevation During Bacterial Shock in Seven Patients Without Apparent Heart Disease
Section snippets
CASE 1
This was a 57-year-old man, a heavy smoker, who had no relevant past medical history. Three days prior to admission, he had fever, right pleuritic chest pain, asthenia, and progressive dyspnea. On admission he was hypotensive and had clinical signs of shock and of respiratory insufficiency. Chest x-ray examination demonstrated a right upper lobe pneumonia, and a normal cardiac size. The ECG was within normal limits (Fig 1). Treatment was begun with penicillin G, intravenous (IV) fluids, and
DISCUSSION
We report the observations of transient ST elevation during treatment of bacterial shock in seven patients who had no history of heart disease. In four patients the maximum ST elevation was equal to or greater than 5 mm. In all patients, the ST segment returned to the isoelectric line within 24 hours, and in five it decreased to 50 percent of the maximal elevation within the first six hours.
Although duration of the ST elevation varied, in no instance did it exceed 24 hours. In addition, no
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