Faculty mentor/PI email address

jim010@aol.com

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Keywords

Systemic infection mimicking acute coronary syndrome, STEMI mimic, Staphylococcus aureus bacteremia, pericardial infection, pericarditis

Date of Presentation

5-6-2026 12:00 AM

Poster Abstract

A 75-year-old female presented to the emergency department (ED) with vomiting, weakness, and altered mental status. Initial evaluation revealed a markedly elevated troponin level and an electrocardiogram (ECG) demonstrating diffuse ST-segment depressions with relative ST elevation in lead aVR, prompting activation of a STEMI alert. After cardiology consultation, emergent catheterization was deferred. Computed tomography (CT) imaging demonstrated an anterior mediastinal fluid collection extending toward the pericardial space with a loculated pericardial effusion. Splenic infarctions were also identified. Blood cultures later grew Staphylococcus aureus. The patient was treated with broad-spectrum antibiotics and transferred to a tertiary care center for further management. This case highlights how systemic infection can mimic acute coronary syndrome and empEasizes the Importance of maintaining a broad differential diagnosis when evaluating elevated troponin and ischemic-appearing ECG findings.

Disciplines

Bacterial Infections and Mycoses | Cardiovascular Diseases | Medicine and Health Sciences

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May 6th, 12:00 AM

A STEMI that Wasn’t: Staphylococcus aureus Bacteremia Presenting With Troponin Elevation and Pericardial Involvement

A 75-year-old female presented to the emergency department (ED) with vomiting, weakness, and altered mental status. Initial evaluation revealed a markedly elevated troponin level and an electrocardiogram (ECG) demonstrating diffuse ST-segment depressions with relative ST elevation in lead aVR, prompting activation of a STEMI alert. After cardiology consultation, emergent catheterization was deferred. Computed tomography (CT) imaging demonstrated an anterior mediastinal fluid collection extending toward the pericardial space with a loculated pericardial effusion. Splenic infarctions were also identified. Blood cultures later grew Staphylococcus aureus. The patient was treated with broad-spectrum antibiotics and transferred to a tertiary care center for further management. This case highlights how systemic infection can mimic acute coronary syndrome and empEasizes the Importance of maintaining a broad differential diagnosis when evaluating elevated troponin and ischemic-appearing ECG findings.

 

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