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Electrocardiographic Changes Associated With Right-sided Pneumothorax

A b s t r A c t Several electrocardiographic (ECG) changes have been described with pneumothorax, most often left-sided. We present a case of spontaneous right-sided pneumothorax, presenting with an ECG suggesting an old myocardial infarction. A chest X-ray confirmed the diagnosis of pneumothorax, while an echocardiogram and serial cardiac enzyme testing excluded myocardial infarction. ECG changes returned to normal after chest tube insertion. Physicians should be familiar with the ECG changes that can be caused by pneumothorax in order to avoid diagnostic and therapeutic pitfalls. A variety of ECG changes have been reported with spontaneous pneumothorax. They range from ST segment elevation suggestive of acute myocardial infarction to diminution of R wave in the precordial leads and inversion of precordial T waves. The major characteristic of these ECG changes is the fact that they return to normal with the resolution of pneumothorax. In most cases it is a left-sided pneumothorax affecting the ECG [1,2]. We present a case of spontaneous right-sided pneumothorax with ECG changes suggestive of an old myocardial infarction.