• Hae Won Jung.
• Department of Cardiology, Daegu Catholic University Medical Center, Daegu, Republic of Korea.
• Medicine (Baltimore). 2021 May 21; 100 (20): e26088e26088.

IntroductionWhen a cancer patient presents with ST-segment elevation on an electrocardiogram (ECG), several causes including acute myocardial infarction (MI) should be considered. Myocardial metastasis is one of the rare causes of ST-segment elevation in cancer patients and its clinical silence makes it difficult to diagnose.Patient ConcernsA 78-year-old man with lung cancer presented to the emergency room for chest pain. ECG revealed ST-segment elevation in inferior and lateral leads.InterventionsAfter emergent coronary angiography, percutaneous coronary intervention (PCI) on proximal right coronary artery was performed.OutcomesEven 7 days after PCI, ST-segment elevation in inferior and lateral leads still existed. Cardiac markers continued to be within the normal range.DiagnosisWe found evidence of metastasis of lung cancer on the inferolateral wall of the myocardium by trans thoracic echocardiogram and positron emission tomography (PET)/computed tomography (CT). We diagnosed myocardial metastasis as the cause of ST-segment elevation in the patient.ConclusionMyocardial metastasis is one of the differential diagnosis of ST-segment elevation in cancer patients. Periodic ECG is necessary for lung cancer patients and rapid cardiac work-up is recommended when ST-segment elevation is newly discovered.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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