ST Segment Elevation in a Patient With Myocardial Metastases

Abstract

A man in his 70s with a history of multiple prior ST-segment elevation myocardial infarctions (STEMIs) and squamous cell carcinoma of the lung with metastatic disease to the brain and myocardium presented to the emergency department with progressive dyspnea on exertion. Ten months prior, the patient developed chest pain and was found to have an inferior STEMI from late in-stent thrombosis, for which he received 2 drug-eluting stents to the right coronary artery. A subsequent transthoracic echocardiogram demonstrated preserved left ventricular systolic function without regional wall motion abnormalities, a moderate pericardial effusion, and a new 2.8 × 2.6-cm mass in the left ventricular mid-apical anteroseptum consistent with a metastatic myocardial tumor (Figure, A). Identify all potential conflicts of interest that might be relevant to your comment. Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. Err on the side of full disclosure. If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response. Not all submitted comments are published. Please see our commenting policy for details.