Key result
Cardiac metastasis occurs in ~44% of autopsied lung cancer patients, occasionally mimicking MI on ECG.
Observational (n=151)
No
In patients with lung cancer, the appearance of progressive ST segment elevation with a QS pattern without cardiac enzyme elevation strongly suggests transmural myocardial metastasis.
May suggest myocardial metastasis on ECG in lung cancer; extends autopsy data but leaves open prospective validation.
Myocardial metastasis from neoplastic disease is often clinically unapparent, and very difficult to diagnose. Of 151 consecutive autopsies of lung cancer patients, cardiac metastases were found in 67 patients (44.4%). Myocardial metastasis was found in only 8 patients (11.9%). ECG of patients with myocardial metastasis revealed ST-T wave changes and various types of arrhythmia. ST-T wave changes were observed in 4 with myocardial metastasis, and in 6 without myocardial metastasis (pericardial metastasis alone). ST-T wave changes is not a specific finding of myocardial metastasis. Two very rare cases with myocardial metastasis showing progressive ST segment elevation with a QS pattern are presented. The appearance of ST segment elevation with a QS pattern in clinically stable lung cancer patients without cardiac symptoms suggestive of myocardial injury indicates the possibility of myocardial metastasis. Myocardial metastasis is often elusive, thus careful observation of ECG changes is of primary importance for the antemortem diagnosis.
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Abe et al. (1991) conducted an observational in Lung cancer (n=151). Myocardial metastasis vs. No myocardial metastasis was evaluated on Incidence of cardiac metastasis and myocardial metastasis. Cardiac metastasis was found in 44.4% of autopsied lung cancer patients, with myocardial metastasis in 11.9% of those, occasionally presenting with myocardial infarction-like ECG changes.
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