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ST-segment elevation due to myocardial invasion of lung cancer mimicking ST elevation myocardial infarction: A case
1Department of Cardiology, Daegu Catholic University Medical Center, Daegu, Republic of Korea.
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.
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