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Chest pain and ST elevation: not always ST-segment-elevation myocardial infarction

Pyxaras, Stylianos A; Lardieri, Geraldina; Milo, Marco; Vitrella, Giancarlo; Sinagra, Gianfranco

Journal of Cardiovascular Medicine: August 2010 - Volume 11 - Issue 8 - p 615–618
doi: 10.2459/JCM.0b013e3283317908
Case reports

A 59-year-old male patient affected by pleural mesothelioma presented with chest pain and localized ST elevation in the electrocardiogram. Urgent coronary angiography excluded an acute coronary occlusion, whereas high-resolution computed tomography of the chest revealed tumor infiltration and associated acute inflammation of the pericardial sac. This case illustrates how initial clinical evaluation during emergency conditions could be misled by the time-effectiveness imperative in the primary percutaneous coronary intervention era. In conclusion, early valorization of clinical signs and noninvasive diagnostic elements may add accuracy in directing the postadmission patient course.

Cardiovascular Department, “Ospedali Riuniti” and University of Trieste, Italy

Received 30 April, 2009

Revised 27 July, 2009

Accepted 3 August, 2009

Correspondence to Prof. Gianfranco Sinagra, MD, FESC, Cardiovascular Department, “Ospedali Riuniti” and University of Trieste, Piazza Valdoni 1, 34100, Trieste, Italy Tel: +39 040 399 4477; fax: +39 040 399 4153; e-mail:

© 2010 Italian Federation of Cardiology. All rights reserved.