10p for an angiogram: the cardio-oesophageal reflex

A 57-year-old man presented at our institution with central chest pain. Serial ECGs showed dynamic T-wave changes, suggesting the possibility of unstable angina. Urgent coronary angiography revealed an unexpected finding of a radio-opaque lesion seen in the xiphisternal region during screening. Oeso...

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Veröffentlicht in:	BMJ case reports 2010-12, Vol.2010 (nov30 1), p.bcr0520091870-bcr0520091870
Hauptverfasser:	Kandan, S R, Augustine, D X, Mansfield, R J, Easaw, J
Format:	Artikel
Sprache:	eng
Schlagworte:	Acute Coronary Syndrome - diagnosis Acute coronary syndromes Angina, Unstable - diagnosis Chest Pain - diagnostic imaging Chest Pain - etiology Coronary Angiography Diagnosis, Differential Electrocardiography Endoscopy, Digestive System Esophagus Europe (West) Foreign Bodies - diagnosis Heart attacks Humans Male Middle Aged Pain Sternum Unusual Association of Diseases/Symptoms White Xiphoid Bone
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Beschreibung
Zusammenfassung:	A 57-year-old man presented at our institution with central chest pain. Serial ECGs showed dynamic T-wave changes, suggesting the possibility of unstable angina. Urgent coronary angiography revealed an unexpected finding of a radio-opaque lesion seen in the xiphisternal region during screening. Oesophogastroduodenoscopy confirmed this to be a 10p coin. The coin passed through the gastrointestinal tract without complications and the patient's symptoms and ECG changes resolved. This unusual case is a reminder that many diseases may electrocardiographically imitate an acute coronary syndrome.
ISSN:	1757-790X 1757-790X
DOI:	10.1136/bcr.05.2009.1870