# An unusual cause of anterior wall ST-elevation myocardial infarction: a case report

## TL;DR

A case of heart attack caused by metastatic lung cancer highlights the need for accurate diagnosis and palliative care in rare, complex situations.

## Contribution

Presents a rare case of tumour-induced myocardial infarction mimicking AMI, emphasizing diagnostic and therapeutic challenges.

## Key findings

- Metastatic lung cancer can mimic acute myocardial infarction with ST-elevation and elevated cardiac enzymes.
- Imaging confirmed tumour infiltration of the coronary artery, leading to unsuccessful intervention attempts.
- The case highlights the importance of palliative care in managing such rare and complex conditions.

## Abstract

Metastatic tumours, notably lung cancer, can cause conditions resembling acute myocardial infarctions (AMIs), 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 attributed to tumour infiltration. Intervention attempts were unsuccessful, and given the palliative context, other revascularization strategies were not pursued. Two-dimensional transthoracic echocardiogram depicted tumour 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 tumours 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.