Mediastinal neuroendocrine tumour presenting with ECG changes: An unusual ST-Elevation Myocardial Infarction mimic

Abstract

A 63-year-old male was referred to the cardiology team with a one month history of progressive chest pain and shortness of breath. This was associated with general decline, weight loss and new heart failure. Emergency Department ECG showed ST elevation throughout the chest leads and blood tests confirmed an elevated troponin. Clinical examination revealed a precordial mass. Bedside echocardiography showed an akinetic anterior wall with infiltration from a mediastinal mass. CT scan demonstrated a large mediastinal mass invading the sternum, ribs and myocardium. Biopsy showed a high grade neuroendocrine tumour of uncertain origin. Despite the need for rapid treatment of ST-Elevation Myocardial Infarction (STEMI), due care needs to be taken to ensure accurate diagnosis.