A Mysterious Case of ST-Elevation Myocardial Infarction; an Old Man with Weight Loss and Dyspepsia

Morteza Safi (Cardiovascular Research Center, Modarres hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran)
Isa Khaheshi (Cardiovascular Research Center, Modarres hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran)
Mehdi Memaryan (Cardiovascular Research Center, Modarres hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran)
Mohammadreza Naderian (Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran)

International Journal of Cardiovascular Practice
Vol. 2 No. 4 (2017)

We present a 65-year-old man who developed retrosternal compressive chest pain. A 12-lead electrocardiography demonstrated ST-segment elevation in leads II, III and aVF. Emergent coronary angiography showed significant thrombus in the distal portion of the left main coronary artery. Abdomino-pelvic computed tomography scan, which was performed the next day, confirmed a pancreatic mass with peritoneal seedings, compatible with peritoneal carcinomatosis. This case underscores the importance of malignancies that may lead to a catastrophic ST-elevation myocardial infarction due to a hypercoagulable state and following thrombosis in the left main coronary artery.