Mocini David, Longo Raffaele, Colivicchi Furio, Morabito Alessandro, Gasparini Giampietro, Santini Massimo
Division of Cardiology, Cardiovascular Department, San Filippo Neri Hospital, Rome, Italy.
Ital Heart J. 2005 Nov;6(11):931-2.
A metastatic involvement of the heart is an uncommon phenomenon in clinical practice; it is more frequent in patients with end-stage disease and a wide tumor spread. The clinical diagnosis is very difficult because there are no early symptoms and most often, the presence of metastases in other sites, such as lung and lymph nodes, may determine a misunderstanding of the clinical picture. We report the case of a young male (44 years old) with a complete atrioventricular block due to metastatic myocardial involvement from a primary occult lung cancer. The first symptom of the disease was a syncopal spell. In spite of permanent pacemaker implantation, the patient died suddenly and unexpectedly after 3 days. Autopsy revealed an anaplastic carcinoma of the right lung hilus. The myocardium was invaded by numerous metastatic nodules, particularly in the interventricular septum and in the left ventricular wall.
心脏转移在临床实践中是一种罕见现象；在终末期疾病且肿瘤广泛扩散的患者中更为常见。临床诊断非常困难，因为没有早期症状，而且大多数情况下，肺部和淋巴结等其他部位出现转移可能会导致对临床表现的误解。我们报告一例年轻男性（44岁）因原发性隐匿性肺癌转移至心肌导致完全性房室传导阻滞的病例。该病的首发症状是一次晕厥发作。尽管植入了永久性起搏器，但患者在3天后突然意外死亡。尸检发现右肺门处有未分化癌。心肌被大量转移结节侵犯，尤其是在室间隔和左心室壁。
