DEPARTMENT OF INTERNAL MEDICINE, JÓZEF STRUS HOSPITAL, POZNAN, POLAND.
PATHOMORPHOLOGY UNIT, JÓZEF STRUS HOSPITAL, POZNAN, POLAND.
Wiad Lek. 2023;76(2):452-457. doi: 10.36740/WLek202302130.
Mechanical heart compression, including that from mediastinal tumor, may cause Brugada-like ECG pattern. Such ECG pattern might also be observed in intracardiac tumor obstructing the right ventricular out"ow tract (RVOT). Eight cases with Brugada-like ECG and tumors involving RVOT have been described so far; 4 growing in the mediastinum (with one example of in"ammatory mass), 3 with intracardiac location, and 1 being an organized pericardial hematoma. The authors present other 3 cases of intracardiac metastatic tumors in RVOT and Brugada-like ECG pattern with coved ST-segment elevation in the right precordial leads. All patients had negative history of cardiovascular disease or familiar malignant arrhythmia occurrence. ECG were done routinely; none of the patients had chest pain or an increased level of cardiac troponins. In all patients, neoplastic disease was at advanced stage. A 76-year-old male, had a history of four neoplasms: bladder cancer was being treated with chemotherapy, while prostate, tongue, and lung cancers had been resected years ago and no signs of local relapse were found. A 78-year-old female, was diagnosed with colon cancer 1 month after an episode of venous thromboembolism. Six months after the resection of cancer, second focus of adenocarcinoma was found in the rectum. Third patient, a 65-year-old-male had undergone nephrectomy for renal cancer a year before cardiac metastasis diagnosis.
机械性心脏压迫,包括纵隔肿瘤引起的心脏压迫,可能导致 Brugada 样心电图模式。这种心电图模式也可能出现在阻塞右心室流出道(RVOT)的心脏内肿瘤中。迄今为止,已有 8 例 Brugada 样心电图和涉及 RVOT 的肿瘤病例被描述;其中 4 例位于纵隔(有 1 例为炎性肿块),3 例位于心脏内,1 例为心包血肿。作者介绍了另外 3 例 RVOT 内的心脏转移性肿瘤和 Brugada 样心电图模式,右胸导联的 ST 段抬高呈拱形。所有患者均无心血管疾病或恶性心律失常家族史。常规进行心电图检查;无胸痛或心肌肌钙蛋白水平升高。所有患者的肿瘤均处于晚期。一名 76 岁男性,患有四种肿瘤:膀胱癌正在接受化疗,而前列腺癌、舌癌和肺癌在几年前已被切除,且未发现局部复发的迹象。一名 78 岁女性,在发生静脉血栓栓塞事件后 1 个月被诊断患有结肠癌。癌症切除后 6 个月,在直肠中发现第二个腺癌病灶。第三例患者为 65 岁男性,在诊断为心脏转移前一年因肾癌行肾切除术。