Lesser Omental Infarction Presenting with ST-Segment Changes on Electrocardiography in A 37-Year Old Male: Coincidence or Causation?

Background: Omental infarction is a rare cause of acute abdominal pain. While the clinical presentation and diagnostic workup of omental infarction have been well-described in the literature, there is currently no published data on the relationship between omental infarction and Electrocardiogram (ECG) changes. Case presentation: A 37-year-old male presented with acute onset of epigastric pain, He had associated ECG changes, including ST elevation in V1 (1 mm), ST depression in leads II, aVF, and V4 so he was diagnosed with omental infarction after exclusion of acute coronary syndrome (ACS) via cardiac catheterization and echocardiography. The patient was managed conservatively with pain control and close observation and was discharged home in stable condition, The ECG changes resolved on follow-up 2 weeks later. Conclusion: Omental infarction should be considered in the differential diagnosis of patients presenting with acute abdominal pain and ECG changes. Further studies are needed to elucidate the pathophysiology of ECG changes in omental infarction and to develop optimal management strategies for these patients.