ST-segment elevation differential diagnosis in a patient with ovarian cancer: A case report

Dehghani-Tafti, Faezeh; Emami-Meybodi, Mahmood; Seyed Hossieni Tezerjani, Seyed Mostafa; Pourkia, Roghayeh

doi:10.48305/arya.2026.45246.3056

ST-segment elevation differential diagnosis in a patient with ovarian cancer: A case report

Document Type : Case Report

Authors

Faezeh Dehghani-Tafti ¹

Mahmood Emami-Meybodi ¹

Seyed Mostafa Seyed Hossieni Tezerjani ¹

Roghayeh Pourkia ²

¹ Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

² Babol University of Medical Sciences, Department of Cardiology, School of Medicine, Babol, Iran

10.48305/arya.2026.45246.3056

Abstract

Across the world the incidence of cancer is predicted to increase by 47% over the next 20 years. Increasingly, cardiologists will be faced with patients presenting with acute coronary syndromes, who are receiving active treatment for cancer. On the other hand, metastasis of malignant tumors to the heart is not usual but can present with various clinical features such as pericardial effusion, heart failure, arrhythmia, and myocardial infarction. Rarely, they may cause characteristic electrocardiographic changes, resembling ST-segment elevated myocardial infarction (STEMI). Decision making in this scenario is complex and requires detailed knowledge of the patient’s cancer stage, response to cancer treatment, and overall prognosis. Proper diagnosis is critical in these patients to prevent unnecessary or even harmful interventions such as fibrinolytic therapy. We reported a 45-year-old woman with a history of ovarian carcinoma, who presented with atypical chest pain and ECG findings suggestive myocardial infarction. But after full investigation we realized these ECG changes were due to the myocardial invasion of the tumor not coronary atherosclerosis and obstruction.

Keywords

Metastatic Tumor

ST-Segment Elevation

Myocardial Infarction

Myocardial Invasion

Secondary Cardiac Tumor

1. Ziccardi MR, Tariq MA, Limaiem F, Ahmed SW. Cardiac cancer. In: StatPearls. 2023. StatPearls Publishing.

2. Zhou J, Zhan C, Zhou J, Wei C, Zou C. Case report: Persistent ST-segment elevation due to cardiac metastasis from lung cancer. Front Cardiovasc Med. 2023 Feb 8;10:1001527. https://doi.org/10.3389/fcvm.2023.1001527

3. Das A, Das SK, Pandit S, Karmakar RN. Bronchogenic Carcinoma with Cardiac Invasion Simulating Acute Myocardial Infarction. Case Rep Oncol Med. 2016;2016:7813509. https://doi.org/10.1155/2016/7813509

4. Bussani R, Castrichini M, Restivo L, Fabris E, Porcari A, Ferro F, et al. Cardiac Tumors: Diagnosis, Prognosis, and Treatment. Curr Cardiol Rep. 2020 Oct 10;22(12):169. https://doi.org/10.1007/s11886-020-01420-z

5. Lichtenberger JP 3rd, Reynolds DA, Keung J, Keung E, Carter BW. Metastasis to the Heart: A Radiologic Approach to Diagnosis With Pathologic Correlation. AJR Am J Roentgenol. 2016 Oct;207(4):764-72. https://doi.org/10.2214/ajr.16.16148

6. Basuoni A, Burney I, Al-Hashami Z, Ahmed M, Kamel AHM, de Oliveira Manoel AL, et al. When cancer reaches the heart: a case series on rare myocardial and endocardial metastases from squamous cell carcinoma. Arch Clin Cases. 2025 Mar 19;12(1):44-50. https://doi.org/10.22551/2025.46.1201.10311

7. Suga T, Akuzawa N, Hatori T, Imai K, Kitahara Y, Kurabayashi M. ST segment elevation in secondary cardiac cancer: a case report and review of the literature. Int J Clin Exp Med. 2015 May 15;8(5):7719-27.

8. Demir V, Turan Y, Ede H, Hidayet S, Erkoç MF. Electrocardiographic changes in right ventricular metastatic cardiac tumor mimicking acute ST elevation myocardial infarction: A case of misdiagnosis. Turk J Emerg Med. 2018 Jul 17;19(1):33-35. https://doi.org/10.1016/j.tjem.2018.07.001

9. Tyebally S, Chen D, Bhattacharyya S, Mughrabi A, Hussain Z, Manisty C, et al. Cardiac Tumors: JACC CardioOncology State-of-the-Art Review. JACC CardioOncol. 2020 Jun 16;2(2):293-311. https://doi.org/10.1016/j.jaccao.2020.05.009