Cardiac Metastasis Presenting as ST-Elevation Myocardial Infarction
1Internal Medicine, Mercyhealth, Rockford, USA.
Insights
A 52-year-old woman with lung cancer experienced shortness of breath and ST-elevation myocardial infarction (STEMI) on ECG. Cardiac MRI revealed metastatic cancer invading the heart muscle, highlighting cardiac metastasis as a STEMI differential diagnosis.
Area of Science:
- Cardiology
- Oncology
Background:
- ST-elevation myocardial infarction (STEMI) typically indicates obstructive coronary artery disease (CAD).
- Cardiac metastasis can present with diverse and sometimes misleading clinical manifestations.
Abstract:
A 52-year-old woman with a history of lung cancer presented with progressive shortness of breath. Her ECG showed evidence of ST-elevation myocardial infarction (STEMI) though no evidence of obstructive coronary artery disease (CAD) was seen on coronary angiography. Further imaging with CT and cardiac MRI (CMRI) demonstrated tumor, likely metastatic cancer, within myocardial tissue. This case is demonstrative of the possible relationship between ST-segment elevation on ECG and corresponding tumor invasion and highlights the differential diagnoses of STEMI, including cardiac metastasis.
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