Accelerated Coronary Artery Disease in a Patient With Advanced Lung Cancer: Interplay of Cancer, Inflammation, and Treatment Effects.

Cardiovascular disease (CVD) and lung cancer are among the most prevalent causes of death worldwide, representing substantial public health challenges. The relationship between coronary artery disease (CAD) and lung cancer is potentially multifaceted, influenced by common risk factors and the adverse cardiac effects of cancer treatments. However, cases of accelerated CAD occurring within a year of cancer treatment initiation are rarely reported. We present a case of a Black American male undergoing combination therapy (chemotherapy/radiotherapy/immunotherapy) for small-cell lung cancer, who developed ST-elevation myocardial infarction (STEMI) seven months after beginning treatment. Although we do not have the official records, the patient reported that he had previously undergone a cardiac workup (including an echo/stress test) at an outside facility a year prior, due to persistent dyspnea, which was unremarkable. The patient underwent successful percutaneous coronary intervention and was discharged on apixaban and prasugrel. This study underscores the importance of maintaining a high index of suspicion for acute coronary syndromes (ACS) in patients receiving lung cancer treatments, emphasizes the need for early recognition of warning signs, and highlights the critical role of risk factor management and enhanced surveillance in this vulnerable population.