Unexplained persistent ST-segment elevation without pathological Q waves in a 61-year-old male with advanced lung cancer was found to be caused by cardiac metastasis.
Case Report (n=1)
Persistent ST-segment elevation without pathological Q waves in patients with advanced cancer should raise suspicion for cardiac metastasis rather than just acute myocardial infarction.
Cardiac metastases are rare in clinical practice. Herein, we describe the case of a 61-year-old male patient who underwent radical left lung cancer surgery > 2 years before the current admission. The postoperative diagnosis was left lung squamous cell carcinoma (stage pT2N1M0/IIB). Post-surgery, he received adjuvant chemotherapy and did not undergo chest radiotherapy. At the current admission, the patient presented with a dull pain in the left side of his chest. Electrocardiography (ECG) revealed ST-segment elevation; repeat troponin and cardiac enzyme levels were negative. Coronary CT showed 55%-77% stenosis in the proximal-mid left anterior descending artery, but no severe occlusive disease in the other major branches. Cardiac ultrasound revealed a 104 × 49 mm hypoechoic mass at the lateral apex without regional wall motion abnormalities or pericardial effusion. Contrast-enhanced chest CT revealed a metastatic tumor in the left anterior mediastinum with invasion of the pericardium and local left ventricular wall. ST-segment elevation on ECG does not always indicate acute myocardial infarction. In patients with advanced cancer, if unexplained persistent ST elevation without pathological Q waves is observed, the possibility of cardiac metastasis should be considered.
Ding et al. (Sun,) conducted a case report in Lung cancer with persistent ST elevation (n=1). Unexplained persistent ST-segment elevation without pathological Q waves in a 61-year-old male with advanced lung cancer was found to be caused by cardiac metastasis.
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