ST-segment elevation differential diagnosis in a patient with ovarian cancer: A case report

Across the world the incidence of cancer is predicted to increase by 47% over the next 20 years. Increasingly, cardiologists will be faced with patients presenting with acute coronary syndromes, who are receiving active treatment for cancer. On the other hand, metastasis of malignant tumors to the heart is not usual but can present with various clinical features such as pericardial effusion, heart failure, arrhythmia, and myocardial infarction. Rarely, they may cause characteristic electrocardiographic changes, resembling ST-segment elevated myocardial infarction (STEMI). Decision making in this scenario is complex and requires detailed knowledge of the patient's cancer stage, response to cancer treatment, and overall prognosis. Proper diagnosis is critical in these patients to prevent unnecessary or even harmful interventions such as fibrinolytic therapy. We reported a 45-year-old woman with a history of ovarian carcinoma, who presented with atypical chest pain and ECG findings suggestive myocardial infarction. But after full investigation we realized these ECG changes were due to the myocardial invasion of the tumor not coronary atherosclerosis and obstruction.