STEMI: rare initial presentation of a mediastinal mass supplied by the RCA.
Publication/Presentation Date
12-29-2019
Abstract
In the setting of severe septic shock, a 70-year-old woman had an ST segment myocardial infarction with ST elevations in the inferolateral leads. On cardiac catheterisation, no obstructive pathology was noted. Chest imaging revealed a large mediastinal mass measuring 8.5×6.5×7.5 cm in the visceral compartment of the mediastinum, with contrast enhancement from the right coronary artery (RCA). A biopsy was preformed and cytology was consistent with a well-differentiated neuroendocrine neoplasm. On review of the cardiac catherisation, it was noted that the mass was deriving blood supply from the RCA. Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a rare but well-documented phenomenon. In this case, MINOCA was caused by coronary steal syndrome in the setting of profound hypotension. Immediate management is with haemodynamic support; there is no role for coronary intervention.
Volume
12
Issue
12
ISSN
1757-790X
Published In/Presented At
Claxton BB, Loloi J, Mrowczynski OD, Abdulbasit M. STEMI: rare initial presentation of a mediastinal mass supplied by the RCA. BMJ Case Rep. 2019 Dec 29;12(12):e231880. doi: 10.1136/bcr-2019-231880. PMID: 31888895; PMCID: PMC6936422.
Disciplines
Medicine and Health Sciences
PubMedID
31888895
Department(s)
Department of Medicine
Document Type
Article