{"title":"前壁 ST 段抬高型心肌梗死的一个不寻常病因:病例报告","authors":"Z. Dindane, Elena Golgor, Axel Linke, N. Mangner","doi":"10.1093/ehjcr/ytae243","DOIUrl":null,"url":null,"abstract":"\n \n \n Metastatic tumors, notably lung cancer, can cause conditions resembling acute myocardial infarctions (AMI), contributing to the minor percentage of AMIs unrelated to coronary atherosclerosis. These instances necessitate specialized diagnostic and therapeutic approaches due to the distinct underlying pathology.\n \n \n \n We report a case of a 65-year-old male with metastatic lung cancer presenting with prolonged angina pectoris. Elevated troponin and creatine kinase levels led to emergency catheterization, revealing a total occlusion of the distal Left Coronary Artery (LCA) attributed to tumor infiltration. Intervention attempts were unsuccessful, and given the palliative context, other revascularization strategies were not pursued. Two-dimensional Transthoracic Echocardiogram (TTE) depicted tumor invasion at the heart’s apex, confirming the diagnosis. The patient passed away shortly after receiving palliative radiation therapy.\n \n \n \n This case underscores the challenges in diagnosing and managing myocardial infiltrations from metastatic tumors mimicking AMI. It accentuates the importance of imaging studies for accurate diagnosis and the critical evaluation of intervention strategies, highlighting the need for focused palliative care in such complex scenarios.\n","PeriodicalId":507701,"journal":{"name":"European Heart Journal - Case Reports","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"An unusual cause of anterior wall ST-elevation myocardial infarction: A case report\",\"authors\":\"Z. Dindane, Elena Golgor, Axel Linke, N. Mangner\",\"doi\":\"10.1093/ehjcr/ytae243\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"\\n \\n \\n Metastatic tumors, notably lung cancer, can cause conditions resembling acute myocardial infarctions (AMI), contributing to the minor percentage of AMIs unrelated to coronary atherosclerosis. These instances necessitate specialized diagnostic and therapeutic approaches due to the distinct underlying pathology.\\n \\n \\n \\n We report a case of a 65-year-old male with metastatic lung cancer presenting with prolonged angina pectoris. Elevated troponin and creatine kinase levels led to emergency catheterization, revealing a total occlusion of the distal Left Coronary Artery (LCA) attributed to tumor infiltration. Intervention attempts were unsuccessful, and given the palliative context, other revascularization strategies were not pursued. Two-dimensional Transthoracic Echocardiogram (TTE) depicted tumor invasion at the heart’s apex, confirming the diagnosis. The patient passed away shortly after receiving palliative radiation therapy.\\n \\n \\n \\n This case underscores the challenges in diagnosing and managing myocardial infiltrations from metastatic tumors mimicking AMI. It accentuates the importance of imaging studies for accurate diagnosis and the critical evaluation of intervention strategies, highlighting the need for focused palliative care in such complex scenarios.\\n\",\"PeriodicalId\":507701,\"journal\":{\"name\":\"European Heart Journal - Case Reports\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-05-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Heart Journal - Case Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1093/ehjcr/ytae243\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Heart Journal - Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/ehjcr/ytae243","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
转移性肿瘤,尤其是肺癌,可引起类似急性心肌梗死(AMI)的症状,在与冠状动脉粥样硬化无关的急性心肌梗死中所占比例很小。由于这些病例的病理基础不同,因此必须采用专门的诊断和治疗方法。 我们报告了一例 65 岁男性转移性肺癌患者的病例,患者表现为长期心绞痛。肌钙蛋白和肌酸激酶水平升高导致患者接受了急诊导管检查,结果显示远端左冠状动脉(LCA)因肿瘤浸润而完全闭塞。介入治疗尝试未获成功,考虑到是姑息治疗,因此没有采取其他血管再通策略。二维经胸超声心动图(TTE)显示肿瘤侵犯心尖,从而确诊了这一诊断。患者在接受姑息放疗后不久去世。 该病例强调了在诊断和处理模仿 AMI 的转移性肿瘤心肌浸润时所面临的挑战。它强调了影像学研究对准确诊断和干预策略关键评估的重要性,突出了在这种复杂情况下进行重点姑息治疗的必要性。
An unusual cause of anterior wall ST-elevation myocardial infarction: A case report
Metastatic tumors, notably lung cancer, can cause conditions resembling acute myocardial infarctions (AMI), contributing to the minor percentage of AMIs unrelated to coronary atherosclerosis. These instances necessitate specialized diagnostic and therapeutic approaches due to the distinct underlying pathology.
We report a case of a 65-year-old male with metastatic lung cancer presenting with prolonged angina pectoris. Elevated troponin and creatine kinase levels led to emergency catheterization, revealing a total occlusion of the distal Left Coronary Artery (LCA) attributed to tumor infiltration. Intervention attempts were unsuccessful, and given the palliative context, other revascularization strategies were not pursued. Two-dimensional Transthoracic Echocardiogram (TTE) depicted tumor invasion at the heart’s apex, confirming the diagnosis. The patient passed away shortly after receiving palliative radiation therapy.
This case underscores the challenges in diagnosing and managing myocardial infiltrations from metastatic tumors mimicking AMI. It accentuates the importance of imaging studies for accurate diagnosis and the critical evaluation of intervention strategies, highlighting the need for focused palliative care in such complex scenarios.