Alteraciones electrocardiográficas en un paciente con hemorragia intracerebral talámica / Electrocardiographical changes in a patient with intracerebral thalamic hemorrhage

Se presenta el caso clínico de un paciente de 67 años de edad, quien ingresó en el Servicio de Neurología del Hospital General Docente Dr Juan Bruno Zayas Alfonso, Santiago de Cuba, con manifestaciones clínicas neurológicas y cifras elevadas de tensión arterial, además de alteraciones electrocardiográficas que semejaban isquemia miocárdica. Ante la ausencia de dolor precordial u otros signos clínicos de isquemia miocárdica fue imposible diagnosticar un síndrome coronario agudo, por lo cual se le realizó una tomografía axial computarizada simple de cráneo, cuyo resultado confirmó que se trataba de una hemorragia intracerebral talámica. Finalmente, los biomarcadores de necrosis miocárdica resultaron negativos.

The case report of a 67 year-old patient is presented who was admitted in the Neurology Service of Dr Juan Bruno Zayas Alfonso Teaching General Hospital, Santiago de Cuba, with neurological clinical manifestations and high values of blood pressure, besides electrocardiographical changes similar to myocardial ischemia. As there was absence of precordial pain or other clinical signs of myocardial ischemia, it was impossible to diagnose an acute coronary syndrome, reason why a simple skull on-line axial tomography was carried out which result confirmed that it was an intracerebralthalamic hemorrhage. Finally, the biomarkers of myocardial necrosis were negative.

Electrocardiographic changes suggesting ischemic heart disease in a case of lung cancer with myocardial metastasis / 대한내과학회지

Metastatic tumors to the myocardium proper are uncommon and difficult to diagnose because they have nonspecific signs and symptoms. Electrocardiogram (ECG) changes mimicking ischemic heart disease often develop when non-conducting tumor tissue replaces cardiac muscle. Hence, a high level of suspicion is required to differentiate ECG changes caused by myocardial metastasis from those caused by coronary heart disease in cancer patients. We describe a case of primary lung cancer with myocardial metastasis that showed diffuse ST segment elevation and T wave inversion on the ECG, with a relevant literature review.