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Kumagai N, Miura SI, Toyoshima H, Koga K, Takeda S, Sato S, Kodama S, Ogawa M, Matsuo K, Nabeshima K, Ishikura H, Watanabe K, Saku K. Acute myocardial infarction due to malignant neoplastic coronary embolus. J Cardiol Cases 2010; 2:e123-e127. [PMID: 30532809 PMCID: PMC6265128 DOI: 10.1016/j.jccase.2010.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Revised: 05/10/2010] [Accepted: 05/18/2010] [Indexed: 10/19/2022] Open
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.
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Affiliation(s)
- Naoko Kumagai
- Department of Cardiology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan
| | - Shin-ichiro Miura
- Department of Cardiology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan
| | - Hideo Toyoshima
- Department of Respiratory Medicine, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Kaori Koga
- Department of Pathology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Satoshi Takeda
- Department of Respiratory Medicine, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Susumu Sato
- Department of Emergency and Critical Care Medicine, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Shiho Kodama
- Department of Pathology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Masahiro Ogawa
- Department of Cardiology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan
| | - Kunihiro Matsuo
- Department of Emergency and Critical Care Medicine, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Kazuki Nabeshima
- Department of Pathology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Hiroyasu Ishikura
- Department of Emergency and Critical Care Medicine, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Kentaro Watanabe
- Department of Respiratory Medicine, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Keijiro Saku
- Department of Cardiology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan
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