Possible pitfalls in the diagnosis of acute myocardial infarction in acutely psychotic patients.
Isr J Psychiatry Relat Sci
; 34(4): 311-4, 1997.
Article
in En
| MEDLINE
| ID: mdl-9409089
ABSTRACT
The disturbed communication of the acutely psychotic patient with Emergency Room (ER) personnel can occasionally lead to a missed or delayed diagnosis of acute myocardial infarction. Conversely, miscommunication may also lead to a false positive diagnosis of acute myocardial ischemia or infarction. We describe a patient who failed to report lithium ingestion because of his psychotic and toxic state. Moreover, the patient was agitated and was treated with intramuscular haloperidol. These factors produced electrocardiographic changes due to the lithium and a rise in serum creatine kinase due to the intramuscular haloperidol, two criteria which could mislead an inexperienced observer to make the false diagnosis of acute myocardial ischemia or infarction. Lithium related electrocardiographic abnormalities and the causes for elevated creatine kinase isoenzymes are reviewed.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Psychotic Disorders
/
Sick Role
/
Myocardial Infarction
Type of study:
Diagnostic_studies
Limits:
Adult
/
Humans
/
Male
Language:
En
Journal:
Isr J Psychiatry Relat Sci
Year:
1997
Document type:
Article
Affiliation country: