Open AccessST-segment elevation due to myocardial invasion of lung cancer mimicking ST elevation myocardial infarction
Author(s) -
Hae Won Jung
Publication year - 2021
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000026088
Subject(s) - medicine , elevation (ballistics) , myocardial infarction , cardiology , lung cancer , st elevation , geometry , mathematics
Abstract Introduction: When a cancer patient presents with ST-segment elevation on an electrocardiogram (ECG), several causes including acute myocardial infarction (MI) should be considered. Myocardial metastasis is one of the rare causes of ST-segment elevation in cancer patients and its clinical silence makes it difficult to diagnose. Patient concerns: A 78-year-old man with lung cancer presented to the emergency room for chest pain. ECG revealed ST-segment elevation in inferior and lateral leads. Interventions: After emergent coronary angiography, percutaneous coronary intervention (PCI) on proximal right coronary artery was performed. Outcomes: Even 7 days after PCI, ST-segment elevation in inferior and lateral leads still existed. Cardiac markers continued to be within the normal range. Diagnosis: We found evidence of metastasis of lung cancer on the inferolateral wall of the myocardium by trans thoracic echocardiogram and positron emission tomography (PET)/computed tomography (CT). We diagnosed myocardial metastasis as the cause of ST-segment elevation in the patient. Conclusion: Myocardial metastasis is one of the differential diagnosis of ST-segment elevation in cancer patients. Periodic ECG is necessary for lung cancer patients and rapid cardiac work-up is recommended when ST-segment elevation is newly discovered.