Cardiac Metastasis Presenting as ST-Elevation Myocardial Infarction

A 52-year-old woman with a history of lung cancer presented with progressive shortness of breath. Her ECG showed evidence of ST-elevation myocardial infarction (STEMI) though no evidence of obstructive coronary artery disease (CAD) was seen on coronary angiography. Further imaging with CT and cardiac MRI (CMRI) demonstrated tumor, likely metastatic cancer, within myocardial tissue. This case is demonstrative of the possible relationship between ST-segment elevation on ECG and corresponding tumor invasion and highlights the differential diagnoses of STEMI, including cardiac metastasis.