Metastatic lesions of the heart can occur in various oncological diseases, but are more often observed in malignant neoplasms of nearby organs. A clinical case of a patient with kidney cancer and cardiac metastases occurring under the guise of acute myocardial infarction (AMI) is presented. In this case, metastases were detected only during a pathological autopsy of the patient. Thus, in a patient with cancer and the clinical picture of AMI, it is necessary to exclude the presence of metastases in the heart, as well as non-coronary causes of increased troponin levels. Correct diagnosis of cardiac metastases plays a decisive role in choosing optimal therapy and improving the prognosis for the patient.