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STEMI stymie: metastatic cancer and cardiac tamponade presenting as inferior STEMI

Murdoch Leeies1, Erin Weldon

  • 1Department of Emergency Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.

Annals of Emergency Medicine
|March 1, 2011
PubMed

Insights

Chest pain with ST-segment elevation mimics myocardial infarction but can indicate cardiac tamponade from occult malignancy. Bedside ultrasonography aids diagnosis in emergency settings.

Area of Science:

  • Cardiology
  • Oncology
  • Emergency Medicine

Background:

  • ST-segment elevation on ECG typically indicates myocardial infarction.
  • Reperfusion strategies carry risks, necessitating consideration of mimics.
  • Pericardial disease is a known mimic of ST-elevation myocardial infarction.

Observation:

  • A patient presented with chest pain and isolated inferior ST-segment elevation.
  • The presentation was suggestive of ST-elevation myocardial infarction.
  • The patient was ultimately diagnosed with cardiac tamponade.

Findings:

  • Cardiac tamponade was the initial presentation of an occult malignancy.
  • This case highlights a rare mimic of ST-elevation myocardial infarction.
  • Bedside ultrasonography proved valuable in diagnosis.

Implications:

  • Clinicians should consider cardiac tamponade in ST-elevation myocardial infarction mimics.
  • Occult malignancy can present as cardiac tamponade.
  • Bedside ultrasonography is crucial for evaluating select cardiac patients and cardiac arrest patients.

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