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• W4387253293 abstract "SESSION TITLE: Disorders of Pleura Case Report Posters 9 SESSION TYPE: Case Report Posters PRESENTED ON: 10/10/2023 09:40 am - 10:25 am INTRODUCTION: Pneumothorax is a common medical condition with a wide variety of clinical presentations, ranging from asymptomatic to life threatening.(1)Some of the underlying lung pathologies that can cause spontaneous pneumothorax include COPD with emphysema, cystic fibrosis, tuberculosis, lung cancer(2)The degree of lung collapse determines the clinical presentation of patients with pneumothorax. (3) The most common symptoms are pleuritic chest pain and shortness of breath(3)Rarely pneumothorax can present as diffuse ST segment elevations on an EKG. We present a case of primary spontaneous pneumothorax on right side presenting with diffuse ST segment elevations on EKG. CASE PRESENTATION: 46 year old male with history of smoking, presented to emergency department for evaluation of right-sided pleuritic chest pain and dyspnea on exertion for 1 day. In the ED, patient was noted to have a generalized ST segment elevations. Chest x-ray was obtained which showed right-sided pneumothorax and bullous disease in the right upper lung with likely rupture of the bullae to cause right pneumothorax. Right chest tube was placed with interval resolution of pneumothorax. The EKG findings completely resolved after chest tube placement. Patient had complete resolution of his symptoms, chest tube was removed in two days and patient was discharged home. DISCUSSION: Pneumothorax in addition to causing classic respiratory symptoms and chest pain can also cause electrophysiological changes. (4)Various theories try to explain the mechanism behind dynamic EKG changes, it is presumed to be secondary to increase intrathoracic pressure leading to decrease cardiac output. (4)Other reported EKG changes associated with pneumothorax include abnormal axis deviation, QRS and T wave changes, QRS voltage variation, QS pattern, PR segment elevation, and S1Q3T3 pattern . (4)ST segment elevations are commonly seen in patients with acute coronary artery syndrome, diffuse ST elevations are usually seen in pericarditis. It is very important to be aware that these changes can rarely be seen in patients with pneumothorax like our patient did. CONCLUSIONS: Practitioners should be aware that pneumothorax can rarely present with ST segment elevations. It is very important to take a detailed history when evaluating these patients in Emergency department so that timely diagnoses can be made and focused treatment initiated as treatment of ST segment elevations secondary to pneumothorax is completely different from similar EKG changes secondary to ACS. REFERENCE #1: 1. DeMaio A, Semaan R. Management of Pneumothorax. Clin Chest Med. 2021;42(4):729-38. REFERENCE #2: 2. Noppen M, De Keukeleire T. Pneumothorax. Respiration. 2008;76(2):121-7. REFERENCE #3: 3. McKnight CL, Burns B. Pneumothorax.4. Yeom SR, Park SW, Kim YD, Ahn BJ, Ahn JH, Wang IJ. Minimal pneumothorax with dynamic changes in ST segment similar to myocardial infarction. Am J Emerg Med. 2017;35(8):19. DISCLOSURES: No relevant relationships by McDonna Hinds No relevant relationships by Reema Rani" @default.
• W4387253293 created "2023-10-03" @default.
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• W4387253293 date "2023-10-01" @default.
• W4387253293 modified "2023-10-03" @default.
• W4387253293 title "RIGHT SIDE PNEUMOTHORAX MIMICKING EKG FINDINGS OF PERICARDITIS IN A YOUNG MALE" @default.
• W4387253293 doi "https://doi.org/10.1016/j.chest.2023.07.2425" @default.
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