Acute myocardial infarction due to malignant neoplastic coronary embolus

Abstract

A 54-year old man was diagnosed with right lung carcinoma (squamous cell carcinoma, SCC), stage IIIB (c-T2N3M0). Transthoracic echocardiography (TTE) showed a huge 8.9 cm × 1.3 cm tumor in the left atrium (LA) that was invaded by a pulmonary vein, and the tumor moved under the mitral valve at LA systole. After 3 months, he was diagnosed with acute myocardial infarction (AMI) and emergency coronary angiography (CAG) was performed. CAG showed that the distal segment of the right coronary artery was totally occluded. TTE showed that the shape of the mass tip became sharp. He was discharged on hospital day 15. He died 4 months after discharge because of right lung carcinoma with respiratory failure. An autopsy showed that the cause of AMI was tumor embolism. SCC clearly occupied a blood vessel lumen in the distal segment. This is a rare case of AMI due to embolism of lung carcinoma during progression of the disease with direct invasion to the LA. TTE is useful for assessing lung carcinoma invasion.

Cardiac arrest due to coronary embolism from a metastatic sarcoma recovered through aspiration thrombectomy

“…Cardiac metastases were reported to have a comparatively higher incidence compared with primary cardiac malignancy (7). In reported cases confirmed by autopsy, the main route of metastatic cancer causing coronary embolism were through the pulmonary veins from lung metastases and direct invasion to the left atrium (3,8). Earlier two cases of coronary embolism were diagnosed by histologic examination through aspiration thrombectomy (3,4).…”

Lung tumor presenting with acute myocardial infarction and lower extremity arterial embolism

“…Acute arterial embolismdue to tumor embolus is a rare complication in cancer patients [2], even rarer is lung tumor embolization leading to AMI. Lung tumor embolization was previously reported to occur in the coronary artery [3][4][5]. Here, we report a case of lung cancer embolus leading to the simultaneous occurrence of AMI and lower extremity arterial embolism.…”

Acute myocardial infarction caused by tumor embolus originating from upper tract urothelial carcinoma: a case report

“…Of the 147 patients with coronary embolism, two patients (1.4%) had malignancy as the etiology for coronary embolism [3]. In patients with malignant coronary tumor embolism, lung carcinoma was the most common source of tumor embolus because lung carcinoma can directly invade the pulmonary vein and left atrium [1]. Lung metastasis could cause coronary tumor embolism via the same mechanism.…”

“…Tumor embolus is rare cause of acute myocardial infarction (AMI). Lung carcinoma was the most common source of coronary malignant tumor emboli, which was caused by direct tumor invasion to pulmonary veins and left atrium [1]. Here, we describe AMI caused by tumor embolus in a patient with upper tract urothelial carcinoma (UTUC).…”