Case report
Imitation of clinical manifestations of myocardial infraction in patients with lung carcinoma
Mirjana Knežević Praveček
Marica Jandrić-Balen
Blaženka Miškić
Pejo Samardžić
Abstract
A 68-year-old man with known coronary artery disease risk factors was admitted to hospital because of acute chest pain, and acute myocardial infarction was initially suspected. Laboratory data showed elevated creatine kinase of MB type values that greatly exceeded the total creatine kinase activity. ECG and Troponin I values were normal. In other laboratory findings there were indicators of liver insufficiency, as well as the presence of azothaemia and thrombocytopenia. Repeated laboratory tests showed constantly elevated CKMB value, without significant ECG findings, and with normal Troponin I values. During the hospitalization, rapid physical deterioration, along with worsening of liver and renal function, as well as thrombocytopenia was noted. The patient soon entered into coma, and died. Microcelullar carcinoma of the lungs was diagnosed during autopsy. Elevated CK-MB value was mostly likely due to presence of CK-BB or macro CK in the plasma. These forms of enzyme interfere with the immunoinhibition methods normally used in laboratories to measure CK-MB and they are reason for false positive increase of CK-MB. It is important to be aware of different causes of CK isoenzyme elevation. When the patient's condition is not compatible with myocardial infarction, malignancy must be considered.
Keywords
Clinical manifestations; Lung carcinoma; Myocardial infarction
Hrčak ID:
190693
URI
Publication date:
1.12.2002.
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