False Angina and Mimic Myocardial Infarction in Wavy Triple Sign (Yasser’s Sign) of Hypocalcemia with later mild COVID-19 Pneumonia-Differentiation and Outcome
Abstract:
Rationale: Tetany is a metabolic disorder due to hypocalcemia that may be associated with musculoskeletal, chest, and cardiac manifestations such as chest pain, tachypnea, and laryngospasm. The wavy triple sign (Yasser’s sign) is a new innovative diagnostic and prognostic sign of hypocalcemia. Despite the quickly swept of COVID-19 across the globe, there is clinical and pathophysiological evidence association between hypocalcemia and COVID-19 pneumonia.
Patient concerns: A 43-year-old widow, housewife, and Egyptian, female patient was presented to the physician outpatient clinic (POC) with angina and tetany after psychogenic hyperventilation. Diagnosis: False angina and mimic myocardial infarction in Wavy triple sign (Yasser’s sign) of hypocalcemia with later mild COVID-19 Pneumonia. Interventions: Electrocardiography, chest CT scan, abdominal ultrasound, oxygenation, and arterial blood gas.
Outcomes: Electrocardiographic and clinical stabilization was the result.
Lessons: The differential diagnosis of Wavy triple ECG sign (Yasser’s sign) of hypocalcemia from acute ST-segment elevation myocardial infarction and ischemic ST-segment depression is critical and pivotal. A Wavy triple ECG sign (Yasser’s sign) of hypocalcemia should be considered as one mimicking acute ST-segment elevation myocardial infarction and ischemic ST-segment depression. Sometimes some included considered clinical associations such as mild COVID-19 pneumonia may be neglected and insignificant in data interpretation.
