Acute urinary retention presenting as inferior pseudo-STEMI: A case report.
Benjamin Morrissey
✦ AI-curated · Sources linked
Case in brief
A 73-year-old man presented with abdominal distension and decreased urination, exhibiting mild hypotension and a palpable bladder extending to the xiphoid. An electrocardiogram revealed inferior ST-segment elevation, prompting further investigation. After Foley catheterization drained approximately 2 L of urine, the ST-segment changes resolved. Blood cultures confirmed bacteremic urosepsis due to Escherichia coli.
What made this case unusual
The case highlights inferior ST-segment elevation due to massive bladder distension without the typical sympathetic activation signs such as tachycardia or hypertension.
Diagnostic / clinical pearl
Clinicians should consider massive bladder distension as a potential cause of inferior ST-segment elevation, especially in the absence of hemodynamic instability.
Why it matters
Recognizing this condition can prevent misdiagnosis of ST-elevation myocardial infarction and unnecessary interventions in similar cases.