Akgun Taylan, Gulsen Kamil, Cinier Göksel, Pay Levent, Uslu Abdulkadir, Kup Ayhan, Akgun Ozge, Ince Orhan, Ozkalayci Flora, Demir Serdar, Kepez Alper
Department of Cardiology, Health and Science University, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey.
Department of Cardiology, Health and Science University, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey.
J Electrocardiol. 2020 Mar-Apr;59:93-99. doi: 10.1016/j.jelectrocard.2019.12.014. Epub 2019 Dec 26.
ST segment elevation (STE) in the standard 12‑lead surface electrocardiography (ECG) is a well-known finding in patients with metastatic cardiac tumors. It is important to identify the specific characteristics of STE among those patients to prevent unnecessary aggressive treatments. In the present study, we aimed to demonstrate the ECG characteristics of patients with metastatic cardiac tumors who has STE.
Medical literature was searched from Pubmed database with key words "metastatic cardiac tumors" or "cardiac tumors" and "ST segment elevation" or "ST elevation". In addition, remaining articles were explored using the references of case reports which were obtained during former screening (snowball procedure).
Thirty six of 46 case reports were included and ECG characteristics of each case were evaluated. Convex- shaped STE was observed in all patients and it showed a specific coronary territory in 35 of 36 patients (97.2%). Pathologic Q wave and/or loss of R wave progression were observed in only one patient. T wave inversion following STE was detected in 34 patients (94.4%). STE evolution was absent in 32 of 36 patients while the information regarding STE evolution were not provided in the remaining cases.
STE due to tumor invasion has certain characteristics which could help clinicians in the differential diagnosis.
在标准12导联体表心电图（ECG）中，ST段抬高（STE）是转移性心脏肿瘤患者的一个众所周知的表现。识别这些患者中STE的具体特征对于避免不必要的积极治疗很重要。在本研究中，我们旨在阐述出现STE的转移性心脏肿瘤患者的心电图特征。
从PubMed数据库中检索医学文献，关键词为“转移性心脏肿瘤”或“心脏肿瘤”以及“ST段抬高”或“ST抬高”。此外，利用在前一轮筛选中获得的病例报告参考文献（滚雪球法）查找其余文章。
纳入了46篇病例报告中的36篇，并对每例的心电图特征进行了评估。所有患者均观察到凸面型STE，36例中的35例（97.2%）显示出特定的冠状动脉区域。仅1例患者观察到病理性Q波和/或R波进展消失。34例患者（94.4%）在STE后检测到T波倒置。36例患者中有32例未观察到STE演变，其余病例未提供有关STE演变的信息。
肿瘤侵犯导致的STE具有某些特征，可帮助临床医生进行鉴别诊断。
