Inferior STEMI Electrocardiogram in a Young Postpartum Female with Sickle Cell Trait with Chest Pain – A Case Report

Division

Far West

Hospital

Riverside Community Hospital

Document Type

Case Report

Publication Date

9-18-2022

Keywords

Sickle cell trait, STEMI, postpartum, vasospasm, ECG, cardiology

Disciplines

Cardiovascular Diseases | Congenital, Hereditary, and Neonatal Diseases and Abnormalities | Emergency Medicine

Abstract

This is a case of a 35-year-old postpartum female presenting to the emergency department (ED) with acute onset chest pain and dyspnea with initial concern for acute ST-segment elevation myocardial infarct (STEMI). Her electrocardiogram (ECG) showed ST segment elevations in the lateral leads and inferior leads with depressions in the high lateral and septal leads. Given her post-partum status, spontaneous coronary artery dissection (SCAD) was part of the differential as well as other emergent processes. Upon cardiac catheterization, the patient was found to have 50% vasospasm in the left circumflex coronary artery. Her post-catheterization echocardiogram showed a normal ejection fraction (EF) without regional wall abnormalities. This is an interesting case of chest pain in a younger patient, without typical acute coronary syndrome (ACS) risk factors, presenting with a concerning ECG likely due to coronary vasospasm. We will discuss other atypical causes of STEMI patterns that should be considered in the differential and management of such patients.

Publisher or Conference

Journal of Education and Teaching in Emergency Medicine

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