Acute pancreatitis mimicking myocardial infarction: potential for inadvertent use of thrombolytic therapy.

Introduction In the recent past the management of a patient suspected of having had an acute myocardial infarction would have been largely conservative (1). Serial electro cardiograms (ECG) and cardiac enzyme estimations would have clarified the diagnosis over the ensuing few days. The advent of thrombolytic therapy has created pressure to make a more rapid and certain diagnosis (2) and to exclude mimicking conditions where the use of this therapy may be hazardous (3, 4, 5). Considerable emphasis has been placed on the inadvertent use of thrombolytics in pericarditis or aortic dissection (2, 4) but less attention has been given to the potential dangers to the patient with acute intra-abdominal pathology presenting with chest pain and ECG abnormalities.