Complete heart block as a herald sign for cardiac lymphoma.
- Resource Type
- Academic Journal
- Authors
- Morgan HP; Cardiology, Royal Gwent Hospital, Newport, South Wales, UK morganhp7@gmail.com.; El-Nayir M; Cardiology, Royal Gwent Hospital, Newport, South Wales, UK.; Jenkins C; Haematology, Royal Gwent Hospital, Newport, South Wales, UK.; Campbell PG; Cardiology, Royal Gwent Hospital, Newport, South Wales, UK.
- Source
- Publisher: BMJ Pub. Group Country of Publication: England NLM ID: 101526291 Publication Model: Electronic Cited Medium: Internet ISSN: 1757-790X (Electronic) Linking ISSN: 1757790X NLM ISO Abbreviation: BMJ Case Rep Subsets: MEDLINE
- Subject
- Language
- English
A previously well 48-year-old man presented with presyncope and was found to be in complete heart block. Blood tests, echocardiography and coronary angiography were reported as normal, and a dual chamber permanent pacemaker was inserted. Six months later he re-presented with breathlessness. His chest X-ray showed cardiomegaly and echocardiography revealed a 4.4 cm pericardial effusion. A CT thorax revealed a mass originating from the intra-atrial septum, extending into the right atrium and ventricle. There were multiple pulmonary lesions suspected to be metastases. Histology demonstrated high-grade B-cell lymphoma. He was treated with eight cycles of R-CHOP chemotherapy and showed good radiological and clinical improvement. Post-treatment echocardiography found severe left ventricular dysfunction with an ejection fraction of <20%. Heart failure medical therapy was optimised and the pacemaker was upgraded to a resynchronisation device. A repeat scan 6 months post device upgrade showed an improvement in ejection fraction to 45%-50%.
Competing Interests: Competing interests: None declared.
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