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Myocardial Infarction with Non-obstructive Coronary Arteries; Diffuse Large B-Cell Lymphoma Presenting as an Acute
Rahul Vilas Deshpande1, Gregory Milne Aroney2, Teng Fong Ng3
1Department of Emergency Medicine, Gold Coast Hospital and Health Service, Queensland, Australia.
Abstract:
A 69-year-old man presented with sudden-onset crushing chest pain, diaphoresis, and syncope with ECG findings prompting treatment as a ST-elevation myocardial infarction (STEMI). Emergency coronary angiography demonstrated no obstructive coronary artery disease. Subsequent investigations including cardiac magnetic resonance imaging (MRI) and positron emission tomography (PET) scan demonstrated an infiltrative mass. Biopsy of a supraclavicular lymph node established a diagnosis of diffuse large B-cell lymphoma (DLBCL) with cardiac involvement. The patient was treated with corticosteroids and immunochemotherapy (DA-R-EPOCH), achieving complete remission on surveillance imaging. This case therefore contributes valuable evidence regarding the varied cardiovascular manifestations of lymphoma and reinforces the importance of maintaining a broad differential diagnosis in patients presenting with features of myocardial infarction with non-obstructive coronary arteries (MINOCA).
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