Celiac sprue presenting as pseudomyocardial infarction

Celiac sprue, also known as celiac disease (CD) or gluten-sensitive enteropathy, is a chronic disorder of the digestive tract that results in an inability to tolerate gliadin, the alcohol-soluble fraction of gluten. We present a case of a patient with CD who was admitted to the emergency department with diarrhea and epigastric and chest pain. The patient had been noncompliant and had eaten some wheat bread. The patient's electrocardiogram showed ST-segment elevations in leads D1 and aVL. Coronary angiography revealed normal coronary arteries. However, emergency coronary angiography ruled out myocardial infarction (MI). As the epigastric pain persisted, a computed tomography was performed, which showed a gastric distension. Decompression of the intestinal tube by the nasogastric tube resulted in normalization of the electrocardiogram. There are very few cases of pseudo-MI with abdominal pathologies. A pseudo-MI in association with CD has not been reported yet. © 2015 Elsevier Inc. All rights reserved.