ECG findings and clinical presentations of myocardial ischemia reported among patients with cardiac metastasis from lung malignancies: A Narrative Review

Objective(s): This narrative review aims at highlighting the ECG findings that are seen among patients with myocardial metastasis resulting from lung cancer. It also analyses the clinical presentations associated with cardiac metastasis. Although ECG findings are not standard means of diagnosis, characteristic changes were reported, which might suggest further investigations for the same.

Data Sources: Published case reports and articles on the topic were collected by searching various databases that include PubMed, Sciencedirect, Hindawi, ResearchGate and AHA journals.

Study Selection: Owing to its rare occurrence, cases reported over a period of over four decades (1981 to 2022) were considered. The keywords used for searching included ‘‘ECG’’, ‘‘Cardiac metastasis’’, ‘‘Myocardial Infarction’’ and ‘‘Lung cancer’’. The studies analysing the ECG findings and presentations of cardiac metastasis resulting from other form of cancers were excluded. Searches were limited to English language.

Data Extraction: Around 43 articles were extracted after initial search. There were only a limited number of articles on this topic after following the exclusion criteria. A total of 35 articles were finally used. The articles used for this narrative review consisted mainly of case reports.

Data Synthesis: A total of 35 studies were included in this review. Assessments of the articles concluded that ECG findings in patients with cardiac metastasis showed ST segment elevation congruent with that of myocardial infarction. Furthermore, though most of the cases do not report any MI-like symptoms at the time of admission, a few reports indicate otherwise. A few case reports reveal patients previously diagnosed with lung cancer to have admitted to hospital presenting with complaints of chest pain, shortness of breath, palpitations and hemoptysis.

Conclusions: This review article encourages health researchers to decipher and justify the findings reported and develop a quicker strategic outline for diagnosis. It also aims to educate the healthcare professionals on the early detection of myocardial metastasis with the study of the preliminary ECG picture, thereby ensuring a better prognosis.

Author(s) Disclosures: N.a