Rare cause of myocardial infarction, stroke, and lung tumour

Our plain-English summary of Rare cause of myocardial infarction, stroke, and lung tumour, by M. Medvegy, A. Szekula, K. Diófalvi, et al (European Heart Journal, 2013).

The study

• Authors: M. Medvegy, A. Szekula, K. Diófalvi, R. Kirschner
• Journal: European Heart Journal
• Published: 2013;34(46):3534
• Type of article: Case report
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This was a one-page case report, published as an illustrated "Cardiovascular Flashlight" item, about a 53-year-old man at a hospital in Hungary. He was admitted with sudden weakness on the right side and slurred speech, and an extensive ischaemic infarct (stroke) was found in the area of the brain supplied by the left posterior cerebral artery. Heart tests suggested a heart attack (myocardial infarction). An ultrasound found a mass in the lower part of the heart, so coronary angiography and surgery were not done. A chest X-ray showed a soft-tissue shadow in the right upper lung, and a CT scan revealed a tumour mass there. The patient died of heart failure on the 9th day in hospital. At autopsy the heart was extensively infiltrated by tumour, the major coronary arteries were intact, and tissue examination described primary malignant mesothelioma of the pericardium (the sac around the heart). The authors attributed the heart attack to blockage of small arteries supplying the heart muscle, caused by an increased tendency of the blood to clot acting together with spread of the tumour into those arteries. The authors concluded that the report shows an uncommon mechanism of heart attack. The article does not mention asbestos or any exposure history.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case report (single patient, illustrated clinical image report)
• Who was studied: One 53-year-old male patient admitted to the Flor Ferenc Hospital of Pest County, Kistarcsa, Hungary, with right-sided hemiparesis and dysarthria; dates not given
• Exposure: Not stated. The article does not mention asbestos, fiber type, occupation, or any other exposure.
• Main results:
  • Autopsy histology in this patient described primary malignant mesothelioma of the pericardium
  • An extensive ischaemic infarct involving the left posterior cerebral artery territory was found; the article does not say which test showed it
  • Echocardiography found a mass in the heart, so coronary angiography and surgery were not considered indicated
  • A chest X-ray showed a soft-tissue shadow in the right upper lung field, and a CT scan revealed a tumour mass there; the article does not give a separate diagnosis for this lung mass
  • The patient died of heart failure on the 9th hospital day
  • At autopsy the major coronary arteries were intact, and a single cerebral ischaemic infarct of 4 cm diameter was found
  • The authors attributed the myocardial infarction to occlusion of small arteries (arterioles) supplying the heart muscle, due to an interaction of hypercoagulability and tumour spread into the arterioles; the illustrations show fibrin microthrombi in vessels of the lung and a tumour thrombus blocking an arteriole in the heart muscle
  • High-sensitive troponin fluctuated from 0.47 to 0.31 to 0.99 mg/L, and histology showed both acute and subacute myocardial infarctions
• The authors' conclusion: The authors concluded that this report introduces an uncommon mechanism responsible for myocardial infarction.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Related studies

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• Mesothelioma and internal carotid artery occlusion: acute ischemic stroke and efficacy of emergency carotid thrombectomy — E. Ferrero, M. Ferri, et al. (2010)
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• Extrapericardial solitary fibrous tumour of the pericardium — S.M. Andreani, L. Tavecchio, et al. (1998)

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