title: STEMI stymie: metastatic cancer and cardiac tamponade presenting as inferior STEMI.
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.
authors.affiliation: Department of Emergency Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Murdoch
authors.initials: M
authors.lastname: Leeies
authors.forename: Erin
authors.initials: E
authors.lastname: Weldon
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D002305:Cardiac Tamponade / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D002637:Chest Pain / Q000175:diagnosis / Q000209:etiology; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D017809:Fatal Outcome; D005260:Female; D006338:Heart Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis*; D013616:Tachycardia, Sinus / Q000175:diagnosis / Q000209:etiology