Left-sided pneumothoraces greater than 30% are often associated with recognizable findings on 12-lead electrocardiograms. In this case study, the electrocardiographic findings were suggestive of acute myocardial infarction. The author discusses the possible causes of the electrocardiographic findings.

A 56-year-old woman (height 165 cm, weight 65 kg) was admitted to the hospital because of a 2-day history of epigastric pain and emesis. Two weeks prior to admission, she had a Billroth II with Roux-en-Y procedure for stomach stricture and biliary reflux. Her medical history was significant for 1 episode of atrial fibrillation many years previously, osteoporosis, bilateral hip replacements, and gastric ulcer surgery. Drug therapy at the time of admission included simethicone 80 mg/d, rabeprazole 10 mg/d, and as-needed doses of clonazepam for anxiety and of acetaminophen.

At admission, the patient’s blood pressure was 120/70 mm Hg and her heart...

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