Sensitivity and Specificity of Electrocardiographic ST-T Changes as Markers of Neoplastic Myocardial Infiltration

Lestuzzi, Chiara; Nicolosi, Gian Luigi; Biasi, Salvatore; Piotti, Patrizia; Zanuttini, D

doi:10.1378/chest.95.5.980

Cited by 23 publications

(13 citation statements)

References 23 publications

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“…ST-T wave changes were observed in four patients. ST-T wave changes seem to be a more specific sign of myocardial injury due to metastasis (3,6). However, Cates et al (3) revealed that ST-Twavechanges are observed not only in patients with myocardial ischemia and injury, but also in patients with pericarditis, hypertensive heart disease and as a result of somedrug treatments.…”

Section: Discussionmentioning

confidence: 99%

Myocardial Metastasis from Primary Lung Cancer: Myocardial Infarction-like ECG Changes and Pathologic Findings.

et al. 1991

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Myocardial metastasis from neoplastic disease is often clinically unapparent, and very difficult to diagnose. Of 151 consecutive autopsies of lung cancer patients, cardiac metastases were found in 67 patients (44.4%). Myocardial metastasis was found in only 8 patients (ll.9%). ECGof patients with myocardial metastasis revealed ST-Twavechanges and various types of arrhythmia. ST-Twavechanges were observed in 4 with myocardial metastasis, and in 6 without myocardial metastasis (pericardial metastasis alone). ST-T wave changes is not a specific finding of myocardial metastasis. Twovery rare cases with myocardial metastasis showing progressive ST segment elevation with a QSpattern are presented. The appearance of ST segment elevation with a QS pattern in clinically stable lung cancer patients without cardiac symptoms suggestive of myocardial injury indicates the possibility of myocardial metastasis. Myocardial metastasis is often elusive, thus careful observation of ECGchanges is of primary importance for the antemortem diagnosis.

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Section: Discussionmentioning

confidence: 99%

Myocardial Metastasis from Primary Lung Cancer: Myocardial Infarction-like ECG Changes and Pathologic Findings.

et al. 1991

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“…'False positives' (ST-T changes without echocardiographic signs of infiltration) can be seen in older patients and in those with pericardial effusion or other heart diseases, with the ST segment elevation proving a more specific sign of myocardial infiltration as compared with negative T waves [29]. Other authors [30] report ECG signs of right or leftventricular hypertrophy.…”

Section: Electrocardiographymentioning

confidence: 99%

Heart and tumors: location, metastasis, clinical manifestations, diagnostic approaches and therapeutic considerations

Ekmektzoglou

Samelis²,

Xanthos³

2008

Journal of Cardiovascular Medicine

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Cardiac neoplasms, whether primary or secondary, are more and more easily diagnosed in the present era. For the primary heart tumors, myxomas and sarcomas constitute the most common neoplasms, whereas for the secondary ones, lung cancer constitutes the most common primary location. Cardiac neoplasms may involve the endocardium, the myocardium, the epicardium, the valves or any combination of these. Their clinical manifestations are not specific and depend on their anatomic location and size. Diagnosis of cardiac neoplasms has become more feasible with the use of echocardiography and other imaging techniques (computed tomography and magnetic resonance). The major problem, however, still remains that most diagnoses are late, especially for malignant tumors. For resectable tumors, surgery remains the mainstay of treatment, whereas for metastatic disease palliative treatment remains the only therapeutic option. This paper reviews the types of heart tumors, their clinical symptoms, the diagnostic approaches and the therapeutic tools used by physicians.

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“…Our patient showed thoracic pain and dyspnoea, with ECG findings mimicking an acute myocardial infarction. Significant ST-T changes were present in a high percentage of patients with myocardial infiltration [9]. ECG false negative patients are mainly seen when the tumour invades only the right heart.…”

Section: Discussionmentioning

confidence: 96%

Atrial flutter and myocardial infarction-like ECG changes as manifestations of left ventricle involvement from lung carcinoma

et al. 2008

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Lung cancer involvement of the heart is not unusual, but in most cases is silent. Arrhythmia and electrocardiographic findings suggesting an acute myocardial infarction could be the first manifestation of myocardial infiltration by the tumour. Echocardiography could be a valuable tool to define the diagnosis in patients with lung cancer and newly diagnosed arrhythmia or ST-T wave alterations. When echocardiographics findings are not conclusive, magnetic resonance imaging (MRI) allows differentiation between tumour and myocardium.

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Sensitivity and Specificity of Electrocardiographic ST-T Changes as Markers of Neoplastic Myocardial Infiltration

Cited by 23 publications

References 23 publications

Myocardial Metastasis from Primary Lung Cancer: Myocardial Infarction-like ECG Changes and Pathologic Findings.

Myocardial Metastasis from Primary Lung Cancer: Myocardial Infarction-like ECG Changes and Pathologic Findings.

Heart and tumors: location, metastasis, clinical manifestations, diagnostic approaches and therapeutic considerations

Atrial flutter and myocardial infarction-like ECG changes as manifestations of left ventricle involvement from lung carcinoma

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