Complete heart block as a herald sign for cardiac lymphoma
- Resource Type
- Authors
- Holly Morgan; Muram El-Nayir; Philip G Campbell; Christopher Jenkins
- Source
- BMJ Case Rep
- Subject
- Thorax
Male
medicine.medical_specialty
Lymphoma, B-Cell
Heart block
medicine.medical_treatment
Case Report
030204 cardiovascular system & hematology
Pericardial effusion
Heart Neoplasms
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Humans
Presyncope
Chemotherapy
Ejection fraction
business.industry
General Medicine
Middle Aged
medicine.disease
medicine.anatomical_structure
Heart Block
Ventricle
Heart failure
Cardiology
business
030215 immunology
- Language
- ISSN
- 1757-790X
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