Abstract
Background
Ingestion of cylindrical batteries is uncommon. Management can include removal via
upper endoscopy, surgical excision, or observation. This case demonstrates the rare
phenomenon of cylindrical battery ingestion causing an electrocardiogram (ECG) artifact
that mimics ST segment myocardial infarction (STEMI).
Case Report
A 51-year-old man who ingested 13 small pencils and 18 AA batteries was found to have
ST segment elevation in the inferior leads of the ECG. Further cardiac workup including
cardiac biomarkers and transthoracic echocardiogram was negative, and his ECG changes
resolved after extraction of the batteries. The ST segment changes were most likely
caused by electrical artifact from battery ingestion.
Why Should an Emergency Physician Be Aware of This?
When faced with an ECG finding that is unexpected and that does not fit the patient's
overall clinical picture, emergency physicians should consider artifact as a possible
cause. Recognition of artifact as the cause of an ECG abnormality can obviate the
need for a prolonged and potentially invasive cardiac workup.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Emergency MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Preventing battery ingestions: an analysis of 8648 cases.Pediatrics. 2010; 125: 1178-1183
- Ingestion of cylindrical and button batteries: an analysis of 2382 cases.Pediatrics. 1992; 89: 747-757
- Endoscopic retrieval vs observation in cylindrical battery ingestion.Ochsner J. 2019; 19: 157-165
- Ingestion of cylindrical batteries and its management.BMJ Case Rep. 2017; 2017 (bcr2016218448)
- Management of ingested foreign bodies and food impactions.Gastrointest Endosc. 2011; 73: 1085-1091
- Cylindrical battery ingestion with electrocardiogram mimicking ST-segment elevation myocardial infarction.J Am Coll Cardiol. 2012; 59: 2387
- Equipment-related electrocardiographic artifacts—causes, characteristics, consequences, and correction.Anesthesiology. 2008; 108: 138-148
- Asymptomatic ST-segment–elevation ECG in patient with kidney failure.Circulation. 2018; 137: 402-404
- Pseudoatrial flutter: artifact simulating atrial flutter caused by a transcutaneous electrical nerve stimulator (TENS).Pacing Clin Electrophysiol. 1997; 20: 3010-3011
- Electrocardiographic artifact mimicking ventricular tachycardia during high-frequency oscillatory ventilation: a case report.Am J Crit Care. 2006; 15: 310-311
- It’s a ST-elevation myocardial infarction (STEMI), or is it? Massive pulmonary embolism presenting as STEMI.J Emerg Med. 2018; 55: 125-127
- Prehospital acute ST-elevation myocardial infarction identification in San Diego: a retrospective analysis of the effect of a new software algorithm.J Emerg Med. 2018; 55: 71-77
- Early repolarization syndrome: diagnostic and therapeutic approach.Front Cardiovasc Med. 2018; 5: 169
- ST depression in lead aVL differentiates inferior ST-elevation myocardial infarction from pericarditis.Am J Emerg Med. 2016; 34: 149-154
Article info
Publication history
Published online: January 27, 2020
Accepted:
December 19,
2019
Received in revised form:
November 5,
2019
Received:
October 8,
2019
Footnotes
Reprints are not available from the authors.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
