ST-elevation Due to Primitive Extracardiac Origin. Differential Diagnosis and Review of Literature

Science Press Release Distribution Services

ST-elevation Due to Primitive Extracardiac Origin. Differential Diagnosis and Review of Literature

July 6, 2021 Medicine and Medical 0

Introduction: The majority of ST elevations are caused by coronary occlusion. A rare case of Acute Myocardial Infarction or artery occlusion has been identified as metastatic disease. Description of the Case: This is the story of a 65-year-old man who was diagnosed with stage IV Thymic Carcinoma in 2012, with two recurrences and a history of surgical treatment followed by radiation and chemotherapy. Since that time, CPAP has been used to treat respiratory failure. He went to the emergency room because his dyspnoea had gotten worse in the last few days. The ECG revealed ST-elevation in DI-aVL and V4-V6, indicating Acute Coronary Syndrome (ACS). The emergency coronary angiogram revealed no significant stenosis of the coronary arteries. The transthoracic echo revealed a mass infiltrating the left ventricular myocardium, resulting in lateral and anterior wall akinesia. A thoracic CT scan revealed a 17*10*12 cm mass that had infiltrated the myocardium surrounding the left circumflex coronary artery, causing ST-elevation. Discussion: Following a multidisciplinary medical evaluation that took into account the clinical context as well as the surgical risk, we decided not to perform any other invasive or bioptic exams. The patient was admitted to the Palliative Care Unit after reaching an agreement with his family. Conclusion: ECG changes caused by metastatic lesions or myocardial infiltration differ from those caused by an ACS. They are distinguished by the persistence of ST-elevation in the absence of typical evolution, such as Q waves or T inversion. Furthermore, in any patient with a history of malignancies, multidisciplinary discussion and multimodality imaging are critical for accurate diagnosis and management.

Author (S) Details

Amabile Valotta
Department of Cardiology, CardioCentroTicino, via Tesserete 48, Lugano 6900, Switzerland.

Lorenzo Grazioli Gauthier
Department of Cardiology, CardioCentroTicino, via Tesserete 48, Lugano 6900, Switzerland.

Marco Moccetti
Department of Cardiology, CardioCentroTicino, via Tesserete 48, Lugano 6900, Switzerland.

View Book :- https://stm.bookpi.org/HMMR-V14/article/view/1650

 

Leave a Reply

Your email address will not be published. Required fields are marked *