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).
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.
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 access
One-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 Medicine
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- 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
Published online: January 27, 2020
Accepted: December 19, 2019
Received in revised form: November 5, 2019
Received: October 8, 2019
Reprints are not available from the authors.
© 2019 Elsevier Inc. All rights reserved.