Liu Alexander, Pusalkar Pawan
AAU, Watford General Hospital, Watford, UK.
BMJ Case Rep. 2011 Jun 29;2011:bcr0320113931. doi: 10.1136/bcr.03.2011.3931.
A 55-year-old gentleman with a left-sided glioblastoma multiforme (GBM) presented with palpitations which were shown to be atrial flutter (AFL) on ECG. Approximately 6 h later, he developed ataxia and expressive dysphasia. A brain CT scan showed no acute haemorrhage and no progression of the brain tumour. Ischaemic stroke was the top differential diagnosis. However, the authors could not perform thrombolysis due to the risk of intratumour haemorrhage. The AFL reverted to sinus rhythm with metoprolol and digoxin after 3 days. His neurological signs resolved within 24 h, and a diagnosis of transient ischaemic attack secondary to AFL was made. This case highlights the challenge of managing thrombo-embolic complications of arrhythmias in cancer patients.
一名55岁的男性患有左侧多形性胶质母细胞瘤（GBM），出现心悸症状，心电图显示为心房扑动（AFL）。大约6小时后，他出现共济失调和表达性失语。脑部CT扫描未显示急性出血，脑肿瘤也无进展。缺血性中风是首要鉴别诊断。然而，由于存在肿瘤内出血的风险，作者无法进行溶栓治疗。3天后，AFL通过美托洛尔和地高辛恢复为窦性心律。他的神经症状在24小时内消失，诊断为AFL继发的短暂性脑缺血发作。该病例凸显了癌症患者心律失常血栓栓塞并发症管理方面的挑战。
