Cardiac Metastasis Presenting With ST-Segment Elevation: Correlation With Multimodality Imaging
Alec Chunta1, Louis Kolman1, Omid Kiamanesh1
1Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, and Libin Cardiovascular Institute, Calgary, Alberta, Canada.
Insights
Cardiac metastasis, though rare, can present subtly. Persistent ST-segment elevation on ECG may indicate cardiac metastasis in cancer patients with heart failure, highlighting the need for advanced imaging.
Area of Science:
- Cardiology
- Oncology
- Radiology
Background:
- Cardiac metastasis is an infrequent clinical diagnosis often obscured by diverse patient presentations.
- Early detection is crucial for managing cancer patients experiencing cardiac symptoms.
Observation:
- An 81-year-old male with a history of metastatic squamous cell carcinoma presented with heart failure.
- Electrocardiogram revealed persistent ST-segment elevation, prompting further investigation.
- Chest computed tomography initially aimed to rule out pulmonary embolism, incidentally identifying a potential cardiac mass.
Findings:
- Multimodality imaging, including echocardiography and cardiac magnetic resonance, confirmed cardiac metastasis.
- Persistent ST-segment elevation on ECG was identified as a potential indicator of cardiac metastasis.
Implications:
- This case underscores the critical role of multimodality imaging in diagnosing cardiac metastasis in oncology patients.
- Persistent ST-segment elevation should be recognized as a potential diagnostic clue for cardiac metastasis, warranting comprehensive cardiac evaluation.
Abstract:
Cardiac metastasis is an uncommon condition that may be missed owing to variability in patient presentation. An 81-year-old man with a history of metastatic squamous cell carcinoma, presenting with heart failure, showed persistent ST-segment elevation on an electrocardiogram. Chest computed tomography, performed to exclude pulmonary embolism, demonstrated possible cardiac mass that was evaluated subsequently with echocardiography and cardiac magnetic resonance. This case shows the importance of multimodality imaging in diagnosing cardiac metastasis in cancer patients with cardiac symptoms. Although the mechanisms are unclear, persistent ST-segment elevations should be considered as a potential clue to the presence of cardiac metastasis.
Related Concept Videos
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
02:30Metastasis
Epithelial-to-Mesenchymal Transition
The epithelial-to-mesenchymal transition or EMT is a developmental process commonly observed in wound healing, embryogenesis, and cancer metastasis. EMT is induced by transforming growth factor-beta (TGF-β) or receptor tyrosine kinase (RTK) ligands, which further...