{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T08:11:10Z","timestamp":1777363870933,"version":"3.51.4"},"reference-count":11,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2021,3,8]],"date-time":"2021-03-08T00:00:00Z","timestamp":1615161600000},"content-version":"unspecified","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,2,23]]},"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:p>ST-elevation myocardial infarction (STEMI) is one of the medical emergencies in cardiology with high morbidity and mortality rate which requires rapid response. In elderly patients, its presenting symptoms may be atypical which may cause the diagnosis of MI to be delayed or missed. Therefore, ST-segment elevation on ECG has become the main instrument for initial diagnosis. However, there are a variety of conditions mimicking the ECG changes of STEMI. We report a case of 70-year-old patient with acute peritonitis and pneumoperitoneum secondary to gastric perforation with dynamic ECG changes mimicking anteroseptal STEMI. After the surgery, the ECG dynamically reverted to normal. He was then discharged after 4\u2009days without any remaining symptoms. Misinterpretation of ECG findings may lead to unnecessary aggressive intervention, costly management strategies and delay in appropriate treatment.<\/jats:p>","DOI":"10.1136\/bcr-2020-237470","type":"journal-article","created":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T10:52:13Z","timestamp":1615287133000},"page":"e237470","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Gastric perforation mimicking ST-segment elevation myocardial infarction"],"prefix":"10.1136","volume":"14","author":[{"given":"Ryan Enast","family":"Intan","sequence":"first","affiliation":[{"name":"Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia"},{"name":"Department of Cardiology and Vascular Medicine, Dr. R. Koesma General Hospital, Tuban, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fani Suslina","family":"Hasibuan","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Vascular Medicine, Dr. R. Koesma General Hospital, Tuban, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parama","family":"Gandi","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga \u2013 Dr. Soetomo General Academic Hospital, Surabaya, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5628-1345","authenticated-orcid":false,"given":"Firas F","family":"Alkaff","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands"},{"name":"Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine Universitas Airlangga, Surabaya, 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