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

doi:https://doi.org/10.21980/J8KP95

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

Jessica Truong^{*^}, Ryan Perdomo, MD^{^}, Daniel Ng, MD^{*^}, Sassan Ghassemzadeh, MD^{*^}and John Costumbrado, MD, MPH^{*^}

^*University of California, Riverside School of Medicine, Riverside, CA

^{^}Riverside Community Hospital, Department of Emergency Medicine, Riverside, CA

Correspondence should be addressed to John Costumbrado, MD, MPH at john.costumbrado@ucr.edu, Twitter: @emriverside1

DOI: https://doi.org/10.21980/J8KP95 Issue 7:4

Cardiology/Vascular Current Issue Visual EM

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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.