What Did a Routine ECG Add During Recovery From Alcohol Withdrawal?

A patient can have an important change in an ECG without reporting chest pain. In a published case, the routine test added information after withdrawal symptoms had begun to improve.

What happened on hospital day ten

The report describes a patient treated for alcohol withdrawal who gradually improved. On day ten, a routine ECG showed inferior ST elevation and a qualitative troponin I test was positive. The authors reported that the patient was oriented and did not report ischemic symptoms at the time. They interpreted the findings as a silent myocardial infarction.

What the record leaves open

The ECG and troponin supplied evidence that the symptom history alone would have missed. The patient declined coronary angiography, leaving the mechanism unresolved. The timing establishes that the event was recognized during withdrawal recovery. It cannot establish that withdrawal caused the cardiac event.

Source

Case report of a silent myocardial infarction during hospitalization for alcohol withdrawal (full text) · DOI