مجلد 1 عدد 1 (2023): Emirati Journal of Future Medicine and Science
Articles

ECG Findings And Clinical Presentations Of Myocardial Ischemia Reported Among Patients With Cardiac Metastasis From Lung Malignancies: A Narrative Review

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  • Swetha Kannan

منشور 2023-06-27

الكلمات المفتاحية

  • ECG,
  • Cardiac Metastasis,
  • Myocardial Infarction,
  • Lung Cancer

كيفية الاقتباس

ECG Findings And Clinical Presentations Of Myocardial Ischemia Reported Among Patients With Cardiac Metastasis From Lung Malignancies: A Narrative Review. (2023). Emirati Journal of Future Medicine and Science, 1(1), 4-11. https://emiratesscholar.com/directory/index.php/ejfms/article/view/72

الملخص

Cardiac tumours are substantially infrequent. However, metastasis to the heart from a primary cancer elsewhere in the body is reported often. In addition to its poor prognosis, the diagnosis of a cardiac metastasis is considered tough to establish. Primary lung cancers contribute to the maximum of cardiac metastasis cases. Owing to its predominantly clinically silent nature, myocardial metastasis isn’t usually detected until autopsy. This narrative review aims at highlighting the ECG findings that are seen among patients with myocardial metastasis resulting from lung cancer. It also analyses the clinical presentations associated with cardiac metastasis. Although ECG findings are not standard means of diagnosis, characteristic changes were reported, which might suggest further investigations for the same. The studies reported in this review were collected from the databases that include PubMed, Sciencedirect, Hindawi, ResearchGate and AHA journals in the period of 1980-2022. The keywords used for searching in the databases included ECG, cardiac metastasis, lung cancer. Articles focusing on lung cancer specifically was included, and studies reporting findings associated with other forms of cancer were excluded. A majority of case reports was used for this review. Literature review showed that ECG findings in a patient with cardiac metastasis imitated that of myocardial infarction. This review article encourages health researchers to decipher and justify the findings reported and develop a quicker strategic outline for diagnosis. It also aims to educate the healthcare professionals on the early detection of myocardial metastasis with the study of the preliminary ECG picture, thereby ensuring a better prognosis. 

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المراجع

  1. Rahouma M, Arisha MJ, Elmously A, et.al. Cardiac tumors prevalence and mortality: A systematic review and meta-analysis. International Journal of Surgery.2020;76:pp178-189. Available from: https://www.sciencedirect.com/science/arti cle/pii/S1743919120302041
  2. Leja MJ, Shah DJ, Reardon MJ. Primary cardiac tumors. Tex Heart Inst J. 2011;38(3):pp261-2. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC3113129/
  3. Bussani R, De-Giorgio F, Abbate A, Silvestri F. Cardiac metastases. J Clin Pathol. 2007 Jan;60(1):pp27-34. doi: 10.1136/jcp.2005.035105. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC1860601/
  4. Goldberg AD, Blankstein R, Padera RF. Tumor metastatic to the heart. Circulation.2013;128:pp1790- 1794.https://doi.org/10.1161/CIRCULATIONAH A.112.000790. Available from: https://www.ahajournals.org/doi/full/10.1161 /circulationaha.112.000790
  5. Cabrera César E, Fernández Aguirre MC, Hidalgo Sanjuan MV. Metástasis cardiacas de una neoplasia pulmonar. Arch Bronconeumol. 2017;53:pp80–81. Available from: https://www.archbronconeumol.org/encardiac-metastases-from-a-lung-articuloS1579212916303299
  6. Shosaku ABE, Naomi WATANABE, Shigeaki OGURA, et.al. Myocardial Metastasis from Primary Lung Cancer: Myocardial Infarctionlike ECG Changes and Pathologic Findings. Japanese Journal of Medicine.1991;30(3):pp213-218. Available from: https://doi.org/10.2169/internalmedicine196 2.30.213
  7. Vallot F, Berghmans T, Delhaye F. et al. Electrocardiographic manifestations of heart metastasis from a primary lung cancer. Support Care Cancer.2001;9:pp275- 277. Available from: https://doi.org/10.1007/s005200000212
  8. Yao NS, Hsu YM, Liu JM, et.al. Lung cancer mimicking acute myocardial infarction on electrocardiogram.The American Journal of Emergency Medicine.1999;17(1):pp86-88. Available from: https://doi.org/10.1016/S0735-6757(99)90026-8
  9. Cates CU, Virmani R, Vaughn WK, et.al. Electrocardiographic markers of cardiac metastases. American Heart Journal.1986;112(6):pp1297-1303Available from:https://doi.org/10.1016/0002-8703(86)90363-7
  10. Konishi S, Kojima T, Ichiyanagi K. et al. A case of double cancers with myocardial metastasis mimicking acute myocardial infarction both on an electrocardiogram and on Tc-99m-MIBI myocardial SPECT. Ann Nucl Med.2001;15:pp381–385 https://doi.org/10.1007/BF02988248
  11. Cheon DY, Park KH, Hong SE, et.al. Metastatic Cardiac Tumor Manifested by Persistent STSegment Elevation With Coexisting Reciprocal Changes on Electrocardiography.International Heart Journal.2014;55(5):pp466-468. https://doi.org/10.1536/ihj.14-050
  12. Pan KI, Wu LS, Chung CM, et.al. Misdiagnosis.International Heart Journal.2007;48(3):pp399- 405.https://doi.org/10.1536/ihj.48.399
  13. Shukla RS, Aggarwal Y. Electrocardiogram in Lung Cancer Patients Envisage as PseudoMyocardial Infarction and Ischemic Heart Disease. Journal of Clinical Engineering.2018; 43(1):pp48-52.DOI: 10.1097/JCE.0000000000000252
  14. Jung HW. ST-segment elevation due to myocardial invasion of lung cancer mimicking ST elevation myocardial infarction: A case report. Medicine (Baltimore).2021;100(20):e26088. doi:10.1097/MD.0000000000026088. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC8137083/
  15. Khurana KV, Ranjan A. ST-Segment Elevation in Conditions of Non-cardiovascular Origin Mimicking an Acute Myocardial Infarction: A Narrative Review. Cureus.2022;14(10):e30868. doi:10.7759/cureus.30868. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC9708054/
  16. Guha S, Mookerjee S, Karmakar RN, et.al. Left atrial extension of lung malignancy with ECG changes resembling MI. Indian Heart J.2010;62:pp81-83. Available from: https://pubmed.ncbi.nlm.nih.gov/21180044/
  17. Shah S, Padaliya B, Mohan SK. Noninfiltrating Adenocarcinoma of the Lung Causing STSegment Elevation. Tex Heart Inst J. 2015;42(4):pp381-4. doi: 10.14503/THIJ-14- 4268. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC4567106/
  18. Kim KH, Jeong MH, Yoon HJ, et.al. A case of myocardial involvement in lung cancer that mimics ST segment elevation in myocardial infarction. Korean J Intern Med.2014;29(4):pp525-8. doi: 10.3904/kjim.2014.29.4.525.Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC4101600/
  19. Luo X, Song N, He S, et.al. Acute ST-segment elevation myocardial infarction due to extrinsic compression of left coronary artery from pulmonary epithelioid hemangioendothelioma: A case report. Medicine (Baltimore). 2019;98(48):e18158. doi: 10.1097/MD.0000000000018158. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6890309/
  20. Anjum I, Eajaz F, Gaffar M, et.al. Myocardial Invasion of Squamous Cell Lung Carcinoma Presenting as STEMI.Heart Views.2022;23(3):pp177-180. doi: 10.4103/heartviews.heartviews_21_22. Available from: ncbi.nlm.nih.gov/pmc/articles/PMC9721171/
  21. Das A, Das SK, Pandit S, et.al.Bronchogenic Carcinoma with Cardiac Invasion Simulating Acute Myocardial Infarction.Case Rep.Oncol Med. 2016;7813509. doi: 10.1155/2016/7813509. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4793133/
  22. Chen T. Persistent ST-segment elevation due to cardiac metastasis. BMJ Case Rep.2017;bcr2017220621.doi: 10.1136/bcr2017-220621. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5623245/
  23. Tandon V, Kethireddy N, Balakumaran K, et.al.Metastatic squamous cell carcinoma to the heart: an unusual cause of ST elevation— a case report, European Heart Journal - Case Reports. 2019;3(2):ytz029. Available from: https://doi.org/10.1093/ehjcr/ytz029
  24. Zhou R, Prasada S, Roth M. 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. Eur Heart J Case Rep. 2021;5(2):ytaa546. doi: 10.1093/ehjcr/ytaa546. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7954242/
  25. Xu J, Cui F, Wang D, et.al. Profound Anterior ST-Segment Elevation in a Patient with Lung Cancer and Echocardiographic Evidence of Right Ventricle Metastasis. CASE (Phila). 2021;6(2):pp59-62. doi: 10.1016/j.case.2021.11.001. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9050599/
  26. Uribarri A, Villa A, Loughlin G, et.al.Acute myocardial infarction as presentation of an infiltrative lung neoplasia. J Cardiol Cases. 2013;7(3):e61-e63. doi: 10.1016/j.jccase.2012.10.013. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6275371/
  27. FANG CF, Geng XU, CHEN YX, WANG, et.al. Acute myocardial infarction mimicking squamous cell lung cancer with bone metastases due to hypercalcemia: a case report. Chinese Medical Journal.2010;123(3):369-371.DOI: 10.3760/cma.j.issn.0366-6999.2010.03.021
  28. Guo-wei CHE, Lun-xu LIU, Er-yong Z, et.al.Left ventricular metastasis from a primary lung carcinoma. Chinese Medical Journal.2007;120(24):pp2323-2324. Available from: https://journals.lww.com/cmj/Fulltext/2007/ 12020/Left_ventricular_metastasis_from_a_p rimary_lung.34.aspx
  29. Joyce NG, Wijayaratna R. A case of solid pericardial metastases causing constrictive pericarditis in a patient with non small cell lung cancer. Australian Medical Student Journal.2013;4(2). Available from: http://amsj.org/wpcontent/uploads/files/articles/amsj_v4_i2/48.pdf
  30. Al-Juburi S, Rafizadeh S, Zeki AA. Heart of the Matter: Syncope as a Rare Presentation of Lung Cancer Invading the Heart. J Investig Med High Impact Case Rep.2021;9:23247096211053709. doi: 10.1177/23247096211053709. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8725212/
  31. Oh J. A Case of Giant Negative T-wave Inversion due to RV Apical Hypertrophy Secondary to Metastatic Lung Cancer. Korean Circulation Journal.2000; 30(11):pp1436-1441. DOI: https://doi.org/10.4070/kcj.2000.30.11.1436
  32. Oyakawa T, Muraoka N, Iida K, et.al. A Patient with a Massive Single Cardiac Metastasis of Lung Adenocarcinoma, Diagnosed via a Biopsy. Intern Med.2018;57(11):pp1637-1640. doi: 10.2169/internalmedicine.9893-17. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6028669/
  33. Kasai T& Kishi, Kazuma & Kawabata, Masateru & Narui, et.al.Cardiac Metastasis From Lung Adenocarcinoma Causing Atrioventricular Block and Left Ventricular Outflow Tract Obstruction. Chest.2007;131:pp1569-72. DOI: http://dx.doi.org/10.1378/chest.06-1904
  34. Son JW, Hong GR. Unusual left ventricular endocardial metastasis from primary lung cancer. J Cardiovasc Ultrasound.2012;20(3):pp157-60. doi: 10.4250/jcu.2012.20.3.157. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3498315/
  35. Burazor I, Aviel-Ronen S, Imazio M. et al. Metastatic cardiac tumors: from clinical presentation through diagnosis to treatment. BMC Cancer.2018;18:202. https://doi.org/10.1186/s12885-018-4070x. Available from:https://bmccancer.biomedcentral.com /articles/10.1186/s12885-018-4070-x