CRCM  Vol.3 No.11 , November 2014
Acute Cholecystitis Mimics Ischemic Cardiac Disease: A Case Report and Review of the Literature
Chest pain and shortness of breath are typical indicators of cardiac problem and may lead to life threatening conditions. Nevertheless, these symptoms may also be associated with a non-cardiac condition clinically such as cholecystitis. We have reported 4 cases in a period of 6 months wherein the patients presented with cardiac-like symptom show ever; they were subsequently diagnosed with non-cardiac problems. Two patients presented with severe chest pain and shortness of breath mimicking angina pectoris. They were admitted to the intensive care unit for emergency management. The ECG findings were normal. There were two other patients who also presented with severe chest pain and shortness of breath with ST segment elevation during the ECG examination. The abdominal ultrasound in all the 4 patients showed typical features of acute calculus cholecystitis. All patients were young (30 - 36 years of age) females who were obese (BMI ranging from 30 - 34). Cholecystectomy was performed which led to improved symptoms postoperatively and ECG changes became normal.

Cite this paper
Habeeb, O. , Ebrahim, T. (2014) Acute Cholecystitis Mimics Ischemic Cardiac Disease: A Case Report and Review of the Literature. Case Reports in Clinical Medicine, 3, 609-615. doi: 10.4236/crcm.2014.311131.
[1]   Ryan, E.T., Pak, P.H. and DeSancts, R.W. (1992) Myocardial Infarction Mimicked by Acute Cholecystitis. Annals of Internal Medicine, 116, 218-220.

[2]   Nasir Javed, M., During, S.J., Sweet, J.M. and Cation Lannine, J. (2006) Chest Pain and ST Segment Elevation Attributable to Cholecystitis: A Case Report. Military Medicine, 171, 1255-1258.

[3]   Pazzilli, R., Barakat, B. and Bartaccini, B. (1963) Electrocardiographic Abnormalities in Acute Pancreatitis. European Journal of Emergency Medicine, 598-602.

[4]   Edat, A.M., Feldman, C., Skoularigis, J. and Swiz, S. (1993) Astudy of Acute Community-Acquired Pneumonia, Including Details of Cardiac Changes. Quarterly Journal of Medicine, 86, 669-675.

[5]   Patel, N., Ariyarathenam, A., Davies, W. and Harris, A. (2011) Acute Cholecystitis Leading to Ischemic ECG Changes in a Patient with No Underlying Cardiac Disease. Journal of the Society of Laparoendoscopic Surgeons, 15, 105-108.

[6]   Frais, M.A. and Rodgers, K. (1990) Dramatic Electrocardiographic T-Waves Changes Associated with Gastric Distension. Chest, 98, 489-490.

[7]   Demerchi, M.S., Regusci, L. and Fasolini, F. (2012) Electrocardiographic Changes and False-Positive Troponin I in a Patient with Acute Cholecystitis. Case Reports in Gastroenterology, 6, 410-414.

[8]   Fred, F. (2014) Ferri, Ferri’s Clinical Advisor. Cholecystitis, 281-281.

[9]   Elsey, J.K. and Schmidt, D.R. (2014) Cholecystitis. Current Surgical Treatment, 387-391

[10]   Cohen, O.J. (1991) Electrocardiographic ST Segment Elevation in Cholecystitis. Hospital Physician, 27, 15-18.

[11]   Kaufman, J.M. and Lubera, R. (1967) Preoperative Use of Atropine and Electrocardiographic Changes. Journal of the American Medical Association, 200, 109-112.

[12]   Brettwlesser, E.R. (1947) Electrocardiographic Observation in Chronic Cholecystitis before and after Surgery. The American Journal of the Medical Sciences, 213, 598-602.

[13]   Gilbert, N.C. (1942) Influence of Extrinsic Factors on the Coronary Flow and Clinical Course of Heart Disease. Bulletin of the New York Academy of Medicine, 18, 83-92.

[14]   Vacca, G., Battaglia, A. and Mary, D.A. (1994) Tachycardia and Pressure Response to Distension of the Gallbladder in the Anaesthetized Pig. Medical Science Research, 22, 697-699.

[15]   Ordway, G.A. and Longhurst, J.C. (1983) Cardiovascular Reflexes Arising from the Gallbladder of the Cat. Effects of Capsaicin, Bradykinin, and Distension. Circulation Research, 52, 26-35.

[16]   Banerjee, S., Linder, M.W. and Singer, I. (2001) False-Positive Troponin I in a Patient with Acute Cholecystitis and Positive Rheumatoid Factor Assay. Cardiology, 95, 170-171.