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一例表现为咯血、胸痛，伴有转移性心肌浸润和左心室壁血栓的ST段抬高型心肌梗死（STEMI）模拟病例报告

A case report of an STEMI mimicker in a patient presenting with haemoptysis and chest pain with metastatic myocardial infiltration and left ventricular mural thrombi.

作者信息

Zhou Ruihai, Prasada Sudhir, Roth Michael

机构信息

Division of Cardiology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Department of Pathology, Nash General Hospital of University of North Carolina Health Care.

出版信息

Eur Heart J Case Rep. 2021 Jan 5;5(2):ytaa546. doi: 10.1093/ehjcr/ytaa546. eCollection 2021 Feb.

DOI:10.1093/ehjcr/ytaa546
PMID:33738407
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7954242/
Abstract

BACKGROUND

ST-elevation myocardial infarction (STEMI) requires timely coronary reperfusion but localizing ST-segment elevation (STE) can develop in clinical settings other than STEMI.

CASE SUMMARY

We report a case of a 66-year-old man, with a history of diabetes mellitus and arthritis presenting with haemoptysis and chest pain. The electrocardiogram (ECG) at presentation showed marked localizing STE but emergent cardiac catheterization showed no significant coronary artery obstruction and the serial serum cardiac troponin levels were within normal limits. The patient was found to have squamous cell carcinoma with a right upper lobe cavitated lung mass and cardiac infiltrative metastasis as shown by computed tomography, echocardiography, cardiac magnetic resonance, and 18F-fluorodeoxyglucosepositron emission tomography-computed tomography (FDG-PET-CT) imaging. Mobile left ventricular mural thrombi were also noted on echocardiography.

DISCUSSION

Metastatic myocardial infiltration can cause STE mimicking STEMI on ECG. The STE is persistent and may reflect an ongoing injury current between the infiltrated and normal myocardium. The STE is localizing, which may have value in evaluating the extent and region of metastatic myocardial damage. Myocardial metastasis can be complicated by ventricular mural thrombosis and due to lack of population data, there is no firm guidance on choice of anticoagulation.

摘要

背景

ST段抬高型心肌梗死（STEMI）需要及时进行冠状动脉再灌注治疗，但ST段抬高（STE）也可能在STEMI以外的临床情况下出现。

病例摘要

我们报告一例66岁男性患者，有糖尿病和关节炎病史，表现为咯血和胸痛。就诊时心电图（ECG）显示明显的局限性STE，但急诊心脏导管检查显示冠状动脉无明显阻塞，系列血清心肌肌钙蛋白水平在正常范围内。计算机断层扫描、超声心动图、心脏磁共振成像和18F-氟脱氧葡萄糖正电子发射断层扫描-计算机断层扫描（FDG-PET-CT）成像显示，该患者患有鳞状细胞癌，右肺上叶有空洞性肺肿块及心脏浸润性转移。超声心动图还发现左心室壁有活动血栓。

讨论

转移性心肌浸润可导致心电图上出现类似STEMI的STE。这种STE持续存在，可能反映了浸润心肌与正常心肌之间持续的损伤电流。这种STE具有局限性，可能对评估转移性心肌损伤的范围和区域有价值。心肌转移可能并发心室壁血栓形成，由于缺乏人群数据，在抗凝治疗的选择上没有明确的指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92b8/7954242/21fc6843fec9/ytaa546f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92b8/7954242/cab407532488/ytaa546f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92b8/7954242/33fb7226858f/ytaa546f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92b8/7954242/b5eb190ebe54/ytaa546f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92b8/7954242/cadfe7b83a5c/ytaa546f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92b8/7954242/b71d629a5fca/ytaa546f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92b8/7954242/21fc6843fec9/ytaa546f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92b8/7954242/cab407532488/ytaa546f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92b8/7954242/33fb7226858f/ytaa546f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92b8/7954242/b5eb190ebe54/ytaa546f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92b8/7954242/cadfe7b83a5c/ytaa546f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92b8/7954242/b71d629a5fca/ytaa546f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92b8/7954242/21fc6843fec9/ytaa546f6.jpg

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本文引用的文献

1
Off-label Use of Direct Oral Anticoagulants Compared With Warfarin for Left Ventricular Thrombi.直接口服抗凝剂与华法林在左心室血栓中的应用比较。
JAMA Cardiol. 2020 Jun 1;5(6):685-692. doi: 10.1001/jamacardio.2020.0652.
2
Noninfiltrating Adenocarcinoma of the Lung Causing ST-Segment Elevation.导致ST段抬高的肺非浸润性腺癌
Tex Heart Inst J. 2015 Aug 1;42(4):381-4. doi: 10.14503/THIJ-14-4268. eCollection 2015 Aug.
3
ST segment elevation in secondary cardiac cancer: a case report and review of the literature.继发性心脏肿瘤中的ST段抬高：一例病例报告并文献复习
一名患有肺癌且有右心室转移超声心动图证据的患者出现深度前壁ST段抬高。
CASE (Phila). 2021 Dec 29;6(2):59-62. doi: 10.1016/j.case.2021.11.001. eCollection 2022 Apr.
4
A rare electrocardiographic evolution and near complete normalization in response to chemoimmunotherapy in a patient with lung cancer and malignant myocardial infiltration: a follow-up case report.一名肺癌合并恶性心肌浸润患者化疗免疫治疗后罕见的心电图演变及近乎完全正常化：病例随访报告
Eur Heart J Case Rep. 2021 Sep 15;5(9):ytab366. doi: 10.1093/ehjcr/ytab366. eCollection 2021 Sep.
Int J Clin Exp Med. 2015 May 15;8(5):7719-27. eCollection 2015.
4
Pronounced and prolonged ST segment elevation: a pathognomonic sign of tumor invasion of the heart.明显且持续的ST段抬高：肿瘤侵犯心脏的特征性征象。
Arch Intern Med. 1982 Oct;142(10):1917-9.