Heart in acute pancreatitis: facts and fictions

Pain is the hallmark of acute pancreatitis and it is localized in the epigastrium in more than 60% of patients having mild or severe disease. Acute pancreatitis may mimic other diseases such as acute coronary syndrome. In addition, the acute illness of the pancreas is associated with a number of metabolic abnormalities, such as hypocalcemia and hypophosphatemia, which may cause hemodynamic changes and variations in the concentration of ionized calcium. In turn, these have been directly correlated to changes in myocardial contractility. The aim of this paper is to review the current literature on the involvement of heart during the course of acute pancreatitis and also to evaluate experimental and clinical data on this topic.