A rare case of acute alcohol intoxication mimicking an electrocardiographic pattern for acute coronary syndrome with ST-segment elevation

  • Franco Lai | franco.lai@uslcentro.toscana.it Emergency Department, Santo Stefano Hospital, Prato, Italy.
  • Lorenzo Pelagatti Emergency Department, Santo Stefano Hospital, Prato, Italy.
  • Chiara Pagnini School of Medicine, University of Florence, Florence, Italy.
  • Alessio Baldini Emergency Department, Santo Stefano Hospital, Prato, Italy.
  • Daniele Versari Emergency Department, Santo Stefano Hospital, Prato, Italy.
  • Simone Magazzini Emergency Department, Santo Stefano Hospital, Prato, Italy.

Abstract

A patient presenting an ST-segment elevation could represent a life-threatening condition in Emergency Department (ED). This case shows how sometimes, a chronic, and more often, an acute abuse of alcohol is related to important harmful effects on myocardial contractility. The authors present a case of a 19-year-old male of oriental-Asiatic origin admitted unconscious to ED with alcoholic fetor: on electrocardiogram a significant and widespread STsegment elevation was observed. A bedside echocardiography showed no abnormalities in segmental kinetics; therefore electrocardiogram- alterations could be related to a coronary spasm. The literature is poor about this effect induced by acute alcohol ingestion: the pathophysiological mechanism at the base of the abnormal muscle contractility, seems to be related to an impairment in cyclic guanosine monophosphate production, although a second and less probable hypothesis could be an altered intracellular concentration of calcium levels.

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Published
2020-04-15
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Issue
Section
Case Reports
Keywords:
Acute alcohol intoxication, ST-segment elevation, coronary vasospasm
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How to Cite
Lai, F., Pelagatti, L., Pagnini, C., Baldini, A., Versari, D., & Magazzini, S. (2020). A rare case of acute alcohol intoxication mimicking an electrocardiographic pattern for acute coronary syndrome with ST-segment elevation. Emergency Care Journal, 16(1). https://doi.org/10.4081/ecj.2020.8596