Lung tumor presenting with acute myocardial infarction and lower extremity arterial embolism

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CASE REPORT

Lung tumor presenting with acute myocardial infarction and lower extremity arterial embolism Jichun Liu1†, Hao Chen2†, Xiangrong Xie1†, Yuwen Yang1* and Shengxing Tang1* 

Abstract  Background:  Lung tumor embolization leading to acute myocardial infarction (AMI) is rare. Previouscases of lung tumor embolization were reported in the coronary artery. We describe here a case of lung tumor embolization leading to the simultaneous occurrence of AMI and lower extremity arterial embolism. Case presentation:  A 64-year-old patient was admitted to the emergency department complaining of chest pain and was diagnosed with AMI.An echocardiography showed a mass in the left atrium that was speculated to be a myxoma. An emergency coronary angiography found no evidence of atherosclerosis. On the second day of admission, the patient was diagnosed with lower extremity arterial embolism. Initially, we speculated that the left atrium myxoma caused an embolism resulting in the AMI and lower extremity arterial embolism.However, a lung tumor was the real cause of both conditions. Unfortunately, the patient abandoned treatment when he learned of his disease and died three days later after being discharged from the hospital. Conclusions:  Lung tumor embolism is an extremely rare cause of AMI. Even rarer is the case presented here, in which a lung tumor embolism caused AMI and lower extremity arterial embolism. Clinicians should recognize lung tumor embolism as a potential cause of AMI. Keywords:  Acute myocardial infarction, Lung tumor, Arterial embolism, Case report Background Acute myocardial infarction(AMI) is usually caused by plaque rupture, erosion, ornodules in the coronary arteries, although other uncommon etiologies exist [1]. Thromboembolism is a common complication in cancer patients. According to pre-existing reports, 4.5% of patients develop venous thromboembolism, and 1.5% of patients develop arterial thromboembolism; these conditions may result from the hypercoagulable state *Correspondence: [email protected]; [email protected] † Jichun Liu,Hao Chen and Xiangrong Xie have contributed equally to this work 1 Department of Cardiology, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College), Wuhu 241001, Anhui, People’s Republic of China Full list of author information is available at the end of the article

associated with cancers. Acute arterial embolismdue to tumor embolus is a rare complication in cancer patients [2], even rarer is lung tumor embolization leading to AMI. Lung tumor embolization was previously reported to occur in the coronary artery [3–5]. Here, we report a case of lung cancer embolus leading to the simultaneous occurrence of AMI and lower extremity arterial embolism.

Case presentation A 64-year-old non-smoking man with no hypertension or diabetes was admitted to the emergency department complaining of oppressive chest pain accompanied by profuse sweating lasting for four hours upon admission. His temperature was 36.1 °C, respiratory r