Key result
Myocardial metastasis of lung cancer was identified as the cause of persistent ST-segment elevation mimicking acute myocardial infarction in a 78-year-old man.
Why the study?
Myocardial metastasis is a rare, clinically silent cause of ST-segment elevation in cancer patients that can be difficult to diagnose.
Case Report (n=1)
Myocardial metastasis is a rare but important differential diagnosis for ST-segment elevation in cancer patients, particularly when cardiac markers remain normal.
Myocardial metastasis merits consideration in cancer patients with unexplained persistent ST elevation; single case leaves open systematic validation.
INTRODUCTION: When a cancer patient presents with ST-segment elevation on an electrocardiogram (ECG), several causes including acute myocardial infarction (MI) should be considered. Myocardial metastasis is one of the rare causes of ST-segment elevation in cancer patients and its clinical silence makes it difficult to diagnose. PATIENT CONCERNS: A 78-year-old man with lung cancer presented to the emergency room for chest pain. ECG revealed ST-segment elevation in inferior and lateral leads. INTERVENTIONS: After emergent coronary angiography, percutaneous coronary intervention (PCI) on proximal right coronary artery was performed. OUTCOMES: Even 7 days after PCI, ST-segment elevation in inferior and lateral leads still existed. Cardiac markers continued to be within the normal range. DIAGNOSIS: We found evidence of metastasis of lung cancer on the inferolateral wall of the myocardium by trans thoracic echocardiogram and positron emission tomography (PET)/computed tomography (CT). We diagnosed myocardial metastasis as the cause of ST-segment elevation in the patient. CONCLUSION: Myocardial metastasis is one of the differential diagnosis of ST-segment elevation in cancer patients. Periodic ECG is necessary for lung cancer patients and rapid cardiac work-up is recommended when ST-segment elevation is newly discovered.
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Hae Won Jung (2021) conducted a case report in ST-segment elevation mimicking myocardial infarction (n=1). Myocardial metastasis was evaluated. Myocardial metastasis of lung cancer was identified as the cause of persistent ST-segment elevation mimicking acute myocardial infarction in a 78-year-old man.
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