Abstract
A man 37 years of age was found to have chest tightness, shortness of breath, and diaphoresis during hospitalization for chemotherapy for metastatic buccal cancer (squamous cell carcinoma) on March 18, 2012. The electrocardiography (ECG) showed ST-segment elevation over V3eV5 leads (Fig. 1B), which was absent on the baseline ECG 1 year ago (Fig. 1A). Although cardiac enzymes were within normal limits, ST-segment elevation myocardial infarction was highly suspected. However, the patient hesitated about coronary angiography due to his terminal cancer status and renal insufficiency (estimated glomerular filtration rate: 29.7 ml/minute/1.73m). Follow-up ECG showed persistent ST-segment elevation without dynamic change. Cardiac enzymes showed extremely low troponin-I value (<0.04 ng/ml at 6 hours, 12
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