Metastatic Breast Carcinoma to the Coronaries: A Rare Cause of Acute Myocardial Infarction.
A 63-year-old female with a history of invasive ductal breast carcinoma presented to the emergency department with symptoms characteristic of myocardial infarction. Electrocardiography showed sinus tachycardia and ST elevations in leads II, III, and aVF, consistent with inferior wall myocardial infarction. A computed tomography (CT) scan of the chest, abdomen, and pelvis with intravenous contrast demonstrated widespread intrathoracic metastatic disease. Cardiac magnetic resonance imaging (MRI) with contrast revealed obstruction of the left ventricular (LV) outflow tract by an LV mass. Cardiac MRI enabled detection of a rare case of myocardial infarction secondary to tumor emboli and intracavitary LV metastasis. This case report emphasizes the role of cross-sectional imaging including CT and cardiac MRI for unusual causes of myocardial infarction, particularly when associated with neoplastic processes.
Case Western Reserve University, Cleveland, Ohio.
Nicholas
N
Bhojwani
Case Western Reserve University, Cleveland, Ohio.
Alok
A
Harwani
Case Western Reserve University, Cleveland, Ohio.
Jason B
JB
Hartman
Case Western Reserve University, Cleveland, Ohio.
Sasan
S
Partovi
Case Western Reserve University, Cleveland, Ohio.
Robert C
RC
Gilkeson
D001943:Breast Neoplasms / Q000150:complications / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000150:complications / Q000175:diagnosis / Q000556:secondary*; D017023:Coronary Angiography; D003331:Coronary Vessels; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D019043:Vascular Neoplasms / Q000150:complications / Q000175:diagnosis / Q000556:secondary*
ST elevation; cardiac MRI; myocardial infarction