ABSTRACT
Myocardial invasion by a neoplasm is a rare occurrence that can present identical signs and symptoms of acute coronary artery disease. We report a case of a 53-year-old man diagnosed with squamous cell lung carcinoma who presented with chest pain and ST-segment elevation on an electrocardiogram. He underwent emergent coronary angiography, which ruled out coronary artery obstruction. An echocardiogram followed by magnetic resonance imaging of the heart confirmed metastatic lung mass in the left ventricular wall. The direct compression of a metastatic tumor on a myocardial wall could lead to ST-segment elevation mimicking acute coronary syndrome. Clinicians should consider metastatic myocardial tumor as a possible cause of ST-segment elevation in patients with nonobstructive coronary arteries and lung carcinoma to prevent misdiagnosis and resultant delayed treatment.
ABSTRACT
OBJECTIVE: To assess the prevalence of risk factors for bleeding and high bleeding risk in patients undergoing percutaneous coronary intervention. METHODS: The single-centre retrospective observational study was conducted at Ittefaq Hospital Lahore and comprised data of patients who underwent percutaneous coronary intervention from February 2018 to December 2019. Minor and major bleeding risk factors were identified on the basis of the consensus definition of the Academic Research Consortium. Patients with high bleeding risk were identified according to the consensus-based criteria of at least one major criterion or two minor criteria. Data was analysed using SPSS 20. RESULTS: Of the 385 patients, 280(72.7%) were males. The overall mean age was 57.9±11.9 years. The indication of procedure was acute coronary syndrome in 367(95%) patients. Of all the patients, 171(45%) had bleeding risk, with 94(24%) patients having a high bleeding risk. Of these, 60(15.6%) patients had high risk based on the presence of at least one major criterion and 34(8.8%) patients because of the presence of two or more minor criteria. Patients with high bleeding risk were more likely to be older and female with more co-morbidities (p<0.05). CONCLUSIONS: Almost half of the patients undergoing percutaneous coronary intervention were found to have at least one bleeding risk factor, and one in four patients had high bleeding risk.
