Related Experiment Video
Updated: Jul 12, 2026

Percutaneous Contrast Echocardiography-guided Intramyocardial Injection and Cell Delivery in a Large Preclinical Model
Published on: January 21, 2018
Inferior STEMI in a Patient With Cardiac Metastasis: A Diagnostic Challenge
Scott Vella Sorensen1, Colby Fischer1, Roberto Herrera1
1Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.
Background:
Cardiac metastases occur more commonly than primary cardiac tumors but are often clinically silent. ST-segment elevation mimicking acute myocardial infarction because of cardiac metastasis is rare.
Case Summary:
We present the case of an 80-year-old woman with advanced pulmonary squamous cell carcinoma and intracardiac metastasis presenting with ST-segment elevations on electrocardiogram. Coronary angiography demonstrated nonobstructive coronary disease. Presentation was thought to be secondary to myocardial infiltration leading to myocyte necrosis. Management focused on symptom control, and the patient ultimately transitioned to hospice care and passed away.
Discussion:
Cardiac metastases can cause ischemic electrocardiographic changes via myocardial invasion, coronary artery compression, or embolization. This case highlights a rare mimic of ST-segment elevation myocardial infarction.
Take-Home Messages:
Cardiac metastases should be considered in cancer patients with findings of ST-segment elevation and nonobstructive coronary disease. Early recognition can guide prognosis, avoid futile interventions, and support timely goals of care discussions.
Related Concept Videos
Metastasis
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...
Acute Coronary Syndrome I: Introduction
Mitral Stenosis II: Clinical features and Diagnostic Tests
Acute Coronary Syndrome III: Diagnostic Studies

