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Coronary Embolization Caused by Pleomorphic Lung Carcinoma

Tadashi Murai1, Taishi Yonetsu, Mitsuaki Isobe

  • 1Department of Cardiology, Tsuchiura Kyodo General Hospital, Japan.

Internal Medicine (Tokyo, Japan)
|December 17, 2016
PubMed

Insights

A rare case of heart attack (ST-segment elevation myocardial infarction) was caused by lung cancer spreading through the pulmonary vein. Doctors removed a tumor embolus during treatment, successfully restoring blood flow.

Area of Science:

  • Cardiology
  • Oncology
  • Pulmonology

Background:

  • ST-segment elevation myocardial infarction (STEMI) is a critical condition usually caused by coronary artery thrombosis.
  • Pulmonary vein invasion by tumors is uncommon and can lead to complex cardiovascular presentations.

Observation:

  • A 73-year-old male presented with acute chest pain diagnosed as STEMI.
  • Intracoronary aspiration retrieved a worm-like object, and revascularization was successful.
  • Imaging revealed a large right upper lobe pulmonary mass with direct pulmonary vein invasion.

Findings:

  • Histopathology confirmed the aspirated object was pleomorphic lung carcinoma.
  • The STEMI was attributed to tumor embolization from the lung mass into the left coronary artery via the pulmonary vein.

Implications:

  • This case highlights an unusual mechanism of myocardial infarction secondary to malignant tumor embolization.
  • It underscores the importance of considering rare etiologies in STEMI, especially with concurrent pulmonary findings.
  • Early diagnosis and intervention are crucial for managing such complex oncological and cardiovascular emergencies.

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