• Yi-Lin Hsieh, Shu-Hao Wu, Chia-Yuan Liu, Wei-Chen Lin, Ming-Jen Chen, and Chen-Wang Chang.
• MacKay Medical College, New Taipei City, Taiwan.
• Medicine (Baltimore). 2024 Feb 16; 103 (7): e37245e37245.

IntroductionAlthough electrocardiographic changes have been previously reported in patients with acute pancreatitis, diffuse ST-segment elevation without occluded coronary arteries is rarely documented.Patient ConcernsA 45-year-old man presented to our emergency department due to persistent epigastric pain for 2 hours. However, ECG in the emergency department revealed regular sinus rhythm at 67 beats per minute, peaked T waves in lead V3-5, and upsloping ST-segment elevation in leads II, III, aVF, and V2-6.DiagnosisHe was diagnosed with acute pancreatitis and presented with diffuse ST-segment elevation.InterventionsLaboratory workup and computed tomography supported the diagnosis of acute gallstone pancreatitis and endoscopic retrograde cholangiopancreatography was performed. Coronary angiography showed patent coronary arteries finally.OutcomesEndoscopic retrograde cholangiopancreatography and endoscopic papillo-sphincterotomy were performed, and the stone in the common bile duct was removed smoothly without immediate complication. Due to his relatively stable condition, he was discharged on day 7 of admission.ConclusionWe presented an uncommon case of acute pancreatitis demonstrating similar features of AMI. This reminds cardiologists and emergency physicians to make the judgment with more caution to avoid jumping to conclusions and providing inappropriate treatment.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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