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Ann Emerg Med. 2011 Mar;57(3):221-4. doi: 10.1016/j.annemergmed.2010.08.011.

STEMI stymie: metastatic cancer and cardiac tamponade presenting as inferior STEMI.

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1
Department of Emergency Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.

Abstract

The combination of chest pain and isolated ST-segment elevation on an ECG immediately suggests the diagnosis of myocardial infarction. However, given the potential for complications associated with reperfusion strategies, clinicians must maintain a high index of suspicion for ST-segment elevation myocardial infarction mimics, including pericardial disease, in their assessment of these patients. Here we report a case that illustrates a rare presentation in which a patient with isolated inferior ST-segment elevation and acute chest pain suggestive of ST-segment elevation myocardial infarction was ultimately diagnosed with cardiac tamponade as the first presentation of an occult malignancy. This case supports the rationale for the use of bedside ultrasonography as a diagnostic modality to include in the evaluation of select cardiac patients and all pulseless electrical activity arrest patients in the emergency department.

[Indexed for MEDLINE]

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