Cardiac metastasis of breast cancer mimicking acute myocardial infarction

A 48-year-old woman was admitted to the coronary care unit because of ventricular tachycardia that developed during hospitalization for invasive ductal carcinoma of the breast. Lidocaine infusion suppressed ventricular tachycardia, and ST-segment elevations in inferior and anterior leads were noted on a subsequent electrocardiogram (ECG). She did not have angina, and serum cardiac troponin T levels were in the normal range. Computed tomography of the thorax revealed metastases involving the myocardium and the lungs. Electrocardiographic abnormalities were attributed to myocardial invasion of the malignant tumor rather than to acute coronary syndrome. Ventricular tachycardia did not recur during follow-up under amiodarone treatment. Myocardial infiltration of the tumor should be considered when ECG alterations without typical angina are found in a patient with malignancy and normal cardiac markers.