Infarction-like electrocardiogram in multimorbidity pathology: a clinical case

A clinical example demonstrates the difficulties of interpreting infarction-like changes on the electrocardiogram in polymorbid pathology. A patient suffering from chronic obstructive pulmonary disease and severe bronchial asthma had two episodes of acute coronary syndrome with changes on the electrocardiogram in the form of ST-segment elevation, increased troponin levels, and was diagnosed with acute myocardial infarction without coronary artery obstruction. The last episode ended in death. Autopsy data for acute and previous myocardial infarction were not found. Post factum analysis of clinical data and the results of additional studies suggest that in this case there was a variant of secondary, recurrent takotsubo syndrome in an elderly woman without an established trigger factor, but against the background of severe polymorbid pathology. The short duration of the patient's stay in the hospital and the severity of her condition did not allow verification of the diagnosis during her lifetime.