Key result
Metastatic thymic carcinoma infiltration mimics ACS by causing persistent ST-elevation without coronary stenosis.
Case Report (n=1)
No
Extracardiac tumors infiltrating the myocardium can present with ST-elevation mimicking acute coronary syndrome, highlighting the importance of multimodality imaging in atypical presentations.
Consider myocardial tumor infiltration in atypical persistent ST-elevation without stenosis; single case leaves open prospective validation of imaging strategies.
This case is about a 65-year-old man with a diagnose of stage IV Thymic Carcinoma in 2012, with two recurrences and past surgical treatment followed by radiation and chemotherapy. From that time, CPAP addicted for respiratory failure. He went to emergency department with worsening dyspnoea in the last few days. The ECG showed an ST-elevation in DI-aVL and V4-V6 suggesting an Acute Coronary Syndrome (ACS). The emergency coronary angiogram showed no significant coronary artery stenosis. The transthoracic echo revealed a mass infiltrating the left ventricular myocardium with consequent akinesia of lateral and anterior wall. A thoracic CT scan revealed a mass of 17*10*12 cm that infiltrated the myocardium surrounding the left circumflex coronary artery, which was the reason of ST-elevation.
No takes yet. Share an insight, caveat, or question.
Valotta et al. (2020) conducted a case report in ST-elevation mimicking Acute Coronary Syndrome (n=1). Myocardial infiltration by metastatic thymic carcinoma was evaluated on Cause of ST-elevation. Myocardial infiltration by a metastatic thymic carcinoma mass caused persistent ST-elevation mimicking an acute coronary syndrome without significant coronary artery stenosis.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: