{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:10:02Z","timestamp":1756372202436,"version":"3.44.0"},"reference-count":11,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,12,11]]},"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:p>In the setting of severe septic shock, a 70-year-old woman had an ST segment myocardial infarction with ST elevations in the inferolateral leads. On cardiac catheterisation, no obstructive pathology was noted. Chest imaging revealed a large mediastinal mass measuring 8.5\u00d76.5\u00d77.5\u2009cm in the visceral compartment of the mediastinum, with contrast enhancement from the right coronary artery (RCA). A biopsy was preformed and cytology was consistent with a well-differentiated neuroendocrine neoplasm. On review of the cardiac catherisation, it was noted that the mass was deriving blood supply from the RCA. Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a rare but well-documented phenomenon. In this case, MINOCA was caused by coronary steal syndrome in the setting of profound hypotension. Immediate management is with haemodynamic support; there is no role for coronary intervention.<\/jats:p>","DOI":"10.1136\/bcr-2019-231880","type":"journal-article","created":{"date-parts":[[2019,12,30]],"date-time":"2019-12-30T04:15:25Z","timestamp":1577679325000},"page":"e231880","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["STEMI: rare initial presentation of a mediastinal mass supplied by the RCA"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1492-3530","authenticated-orcid":false,"given":"Benjamin B","family":"Claxton","sequence":"first","affiliation":[{"name":"Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4802-3354","authenticated-orcid":false,"given":"Justin","family":"Loloi","sequence":"additional","affiliation":[{"name":"Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3860-1309","authenticated-orcid":false,"given":"Oliver D","family":"Mrowczynski","sequence":"additional","affiliation":[{"name":"Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2506-2019","authenticated-orcid":false,"given":"Muhammad","family":"Abdulbasit","sequence":"additional","affiliation":[{"name":"Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,12,29]]},"reference":[{"key":"2025082801471111000_12.12.e231880.1","doi-asserted-by":"crossref","DOI":"10.12703\/P7-08","article-title":"Pathophysiology of coronary artery disease leading to acute coronary syndromes","volume":"7","author":"Ambrose","year":"2015","journal-title":"F1000Prime Rep"},{"key":"2025082801471111000_12.12.e231880.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.11.018"},{"key":"2025082801471111000_12.12.e231880.3","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.53.4.363"},{"key":"2025082801471111000_12.12.e231880.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.08.1038"},{"key":"2025082801471111000_12.12.e231880.5","doi-asserted-by":"publisher","DOI":"10.1007\/BF03086173"},{"key":"2025082801471111000_12.12.e231880.6","doi-asserted-by":"publisher","DOI":"10.1053\/euhj.2000.2553"},{"key":"2025082801471111000_12.12.e231880.7","doi-asserted-by":"crossref","unstructured":"Gue YX , Anwar M , Gorog DA . 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