Department of Cardiology, St Helens and Knowsley Teaching Hospitals NHS Trust, Prescot, UK.
Department of Cardiology, St Helens and Knowsley Teaching Hospitals NHS Trust, Prescot, UK
BMJ Case Rep. 2022 May 25;15(5):e247658. doi: 10.1136/bcr-2021-247658.
A man in his mid-50s presented with palpitations, chest pain and syncope. After initial workup for a non-ST elevation myocardial infarction, a CT scan revealed metastatic melanoma. The malignancy was infiltrating his right ventricle, resulting in recurrent ventricular tachycardia. Although initially hard to manage, his arrhythmias were eventually controlled with medication. Unfortunately, despite an initial response to immunotherapy, he died six months after diagnosis.Cardiac metastases are rare, but melanoma has a high predication for metastasising to the heart and a small number of cases of such metastases causing ventricular arrhythmias have previously been reported. This case shows the importance of concurrent investigations when patients report multiple, seemingly unrelated symptoms as a unifying diagnosis may be uncovered.
一位 50 多岁的男性出现心悸、胸痛和晕厥。在对非 ST 段抬高型心肌梗死进行初步检查后，CT 扫描显示转移性黑色素瘤。恶性肿瘤浸润他的右心室，导致反复出现室性心动过速。尽管最初难以控制，但他的心律失常最终通过药物得到控制。不幸的是，尽管他对免疫疗法有初步反应，但他在诊断后六个月去世。心脏转移瘤很少见，但黑色素瘤有很高的转移到心脏的预测，以前曾有少数此类转移导致室性心律失常的病例报告。本病例表明，当患者报告多个看似无关的症状时，进行同时检查很重要，因为可能会发现一个统一的诊断。
