Electrocardiographic changes in lung cancer. Be careful not to misdiagnose: acute coronary event? meta? inflammation?

In cancer patients changes in the electrocardiogram (ECG) may indicate various causes. The presented case concerns a patient with advanced left lung cancer who presented deep inversion of T waves during ongoing chemotherapy. We excluded acute coronary syndrome, acute pulmonary embolism, and myocarditis. Subsequently, we suspected metastases to the myocardium; therefore, we performed cardiac magnetic resonance imaging, which however did not confirm that. The cardiac magnetic resonance imaging showed residual post-inflammatory changes in the left lung. We publish this case to show that the inflammatory process of lung segments adjacent to the heart may cause temporal myocardial oedema, resulting in ECG changes that may mimic acute coronary events.