Matsuo T, Nishiura R, Tsumori Y, Maeno M, Kumagae H, Imamura T, Koiwaya Y, Eto T, Nagamine H, Inoue S
First Department of Internal Medicine, Miyazaki Medical College.
J Cardiol. 1999 Dec;34(6):345-9.
A 77-year-old man with malignant lymphoma presented with dizziness and exertional dyspnea. Physical examination revealed marked bradycardia (36 beats/min). Twelve-lead electrocardiography showed complete atrioventricular block with narrow QRS escape beats. Gallium scintigraphy demonstrated significant abnormal uptake in the heart. Transesophageal echocardiography showed a thick interatrial septum with increased echogenecity. He underwent chemotherapy under external temporary pacing with a suspected diagnosis of complete atrioventricular block secondary to cardiac invasion of malignant lymphoma. Atrioventricular conduction progressively improved and the complete atrioventricular block disappeared. He is currently well and has required no cardiac pacing for 6 months. We conclude that complete atrioventricular block may be reversible in some patients with malignant lymphoma, even in the elderly.
一名77岁的恶性淋巴瘤男性患者出现头晕和劳力性呼吸困难。体格检查发现显著心动过缓（36次/分钟）。十二导联心电图显示完全性房室传导阻滞伴窄QRS逸搏。镓闪烁扫描显示心脏有明显异常摄取。经食管超声心动图显示房间隔增厚，回声增强。他在临时体外起搏下接受化疗，疑似诊断为恶性淋巴瘤心脏浸润继发的完全性房室传导阻滞。房室传导逐渐改善，完全性房室传导阻滞消失。他目前情况良好，6个月来无需心脏起搏。我们得出结论，即使是老年患者，某些恶性淋巴瘤患者的完全性房室传导阻滞也可能是可逆的。
