ST-Segment elevation: Not always

Érico Costa; Elsa Meireles; Catarina Rodrigues; Tiago Godinho  Teixeira; Dulce Silva

doi:10.21859/ijcp-020102

International Journal of Cardiovascular Practice

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https://doi.org/10.21859/ijcp-020102

ST-Segment elevation: Not always

Author(s):

Érico Costa¹,

Elsa Meireles¹,

Catarina Rodrigues²,

Tiago Godinho Teixeira ^3,*,

Dulce Silva¹

1Internal Medicine Department, Centro Hospitalar Entre Douro e Vouga, Santa Maria da Feira, Portugal

2Oncology Department, Centro Hospitalar Entre Douro e Vouga, Santa Maria da Feira, Portugal

3Cardiology Department, Centro Hospitalar Entre Douro e Vouga, Santa Maria da Feira, Portugal

International Journal of Cardiovascular Practice:Vol. 2, issue 1; 21-23

Published online:Jan 24, 2017

Article type:Case Report

Received:Oct 21, 2016

Accepted:Nov 30, 2016

How to Cite:Érico CostaElsa MeirelesCatarina RodriguesTiago Godinho Teixeira Dulce SilvaST-Segment elevation: Not always.Int J Cardiovasc Pract.2(1):e130055.https://doi.org/10.21859/ijcp-020102.

Abstract

Cardiac tumors can be primary or metastatic, the latter being more frequent and usually of pulmonary or hematologic origin. These patients’ clinical signs are non-specific and the electrocardiogram (ECG) can assume many patterns, among which, ST-segment elevation. Nevertheless, associated occlusion of the coronary arteries is rare in these situations.
We present a 79-year-old woman with a history of pulmonary neoplasia who was admitted to the emergency department due to prolonged atypical chest pain, cough and worsening dyspnea in the previous 3 days. The ECG revealed an ST-segment elevation in the lateral leads, despite normal blood work, with only residually elevated troponin I. Due to the disparity between the patient’s symptoms and the ECG findings, a decision was made not to proceed to primary angioplasty, but to further investigate with echocardiography, which revealed a mass localized in the anterolateral and inferolateral left ventricle walls, confirmed by computed tomography. The patient was admitted in the medical ward for symptomatic management. Her clinical condition gradually deteriorated due to the disease’s natural evolution and she died two weeks later.
This case highlights the importance to keep in mind differential diagnoses to acute coronary syndromes, when a ST-segment elevation is encountered on a ECG.

Keywords

Cardiac Metastasis

ST-segment Elevation

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Author(s):

Érico Costa:[PubMed][Scholar]
Elsa Meireles:[PubMed][Scholar]
Catarina Rodrigues:[PubMed][Scholar]
Tiago Godinho Teixeira :[PubMed][Scholar]
Dulce Silva:[PubMed][Scholar]