{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T14:08:42Z","timestamp":1780582122433,"version":"3.54.1"},"reference-count":7,"publisher":"SMC Media","issue":"6","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background:\u00a0Caustic ingestion remains a significant clinical challenge, often resulting in severe transmural oesophageal injury. Given the immediate anatomical proximity of the oesophagus to the left atrium and ventricle, severe inflammation can extend to adjacent cardiac structures, potentially mimicking acute coronary syndrome. Case description:\u00a0A 22-year-old male presented following the intentional ingestion of sodium hydroxide drain cleaner. Initial endoscopy identified injury that rapidly progressed from Zargar grade 1 to 3B. Simultaneously, the patient developed acute ST-segment elevation and a marked troponin elevation of 85.15 ng\/ml. Despite these findings, echocardiography confirmed normal ventricular function and no pericardial effusion. Managed conservatively with multidisciplinary support, the patient\u2019s electrocardiographic abnormalities showed progressive normalization that correlated with clinical improvement of the oesophageal injury. Unfortunately, the patient succumbed to pulmonary and vascular complications 28 days later. Conclusion:\u00a0Severe transmural esophagitis can produce dramatic, reversible cardiac manifestations through direct inflammatory extension. This case highlights the importance of recognizing non-cardiac causes of ST-segment elevation to avoid unnecessary, high-risk cardiac interventions in critically ill patients. Serial electrocardiograms may serve as a non-invasive marker reflecting the severity and progression of underlying oesophageal necrosis.<\/jats:p>","DOI":"10.12890\/2026_006564","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T09:02:09Z","timestamp":1778749329000},"source":"Crossref","is-referenced-by-count":0,"title":["Reversible ST-segment elevation in the setting of acute esophagitis caused by caustic drain cleaner ingestion"],"prefix":"10.12890","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1535-4680","authenticated-orcid":false,"given":"Ahmed","family":"Ali","sequence":"first","affiliation":[{"name":"Creighton University School of Medicine, Omaha, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6190-2575","authenticated-orcid":false,"given":"Ahmed","family":"Awab","sequence":"first","affiliation":[{"name":"Pulmonary, University of Oklahoma Health Sciences Center, Oklahoma City, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7005-0378","authenticated-orcid":false,"given":"Hafiz","family":"Fakih","sequence":"first","affiliation":[{"name":"Pulmonary, University of Oklahoma Health Sciences Center, Oklahoma City, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10397","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"key":"10.12890\/2026_006564_ref1","doi-asserted-by":"crossref","unstructured":"Park KS. Evaluation and management of caustic injuries from ingestion of acid or alkaline substances. Clin Endosc 2014;47:301-307. doi: 10.5946\/ce.2014.47.4.301","DOI":"10.5946\/ce.2014.47.4.301"},{"key":"10.12890\/2026_006564_ref2","doi-asserted-by":"crossref","unstructured":"Zhang J, Basrawala H, Patel S, Girn H, Eyvazian V, Wang L, et al. Gastrointestinal distention masquerading as ST-segment elevation myocardial infarction. JACC Case Rep 2020;2:604-610. doi: 10.1016\/j.jaccas.2020.02.016","DOI":"10.1016\/j.jaccas.2020.02.016"},{"key":"10.12890\/2026_006564_ref3","doi-asserted-by":"crossref","unstructured":"Wang K, Asinger RW, Marriott HJ. ST-segment elevation in conditions other than acute myocardial infarction. N Engl J Med 2003;349:2128-2135. doi: 10.1056\/nejmra022580","DOI":"10.1056\/NEJMra022580"},{"key":"10.12890\/2026_006564_ref4","doi-asserted-by":"crossref","unstructured":"Zargar SA, Kochhar R, Nagi B, Mehta S, Mehta SK. Ingestion of corrosive acids. Spectrum of injury to upper gastrointestinal tract and natural history. Gastroenterology 1989;97:702-707. doi: 10.1016\/0016-5085(89)90632-0","DOI":"10.1016\/0016-5085(89)90641-0"},{"key":"10.12890\/2026_006564_ref5","doi-asserted-by":"crossref","unstructured":"Hussain N. Elevated cardiac troponins in setting of systemic inflammatory response syndrome, sepsis, and septic shock. ISRN Cardiol 2013;2013:723435. doi: 10.1155\/2013\/723435","DOI":"10.1155\/2013\/723435"},{"key":"10.12890\/2026_006564_ref6","doi-asserted-by":"crossref","unstructured":"Chirica M, Bonavina L, Kelly MD, Sarfati E, Cattan P. Caustic ingestion. Lancet 2017;389:2041-2052. doi: 10.1016\/S0140-6736(16)30313-0","DOI":"10.1016\/S0140-6736(16)30313-0"},{"key":"10.12890\/2026_006564_ref7","doi-asserted-by":"crossref","unstructured":"Agewall S, Giannitsis E, Jernberg T, Katus H. Troponin elevation in coronary vs. non-coronary disease. 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