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22-11-2019 | Heart Beat | Uitgave 9/2020 Open Access

Netherlands Heart Journal 9/2020

ST-segment elevation in a patient with cardiac lymphoma

Netherlands Heart Journal > Uitgave 9/2020
J. P. Guimarães, J. Trigo, F. Fonçalves, J. I. Moreira
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Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s12471-019-01345-5) contains supplementary material, which is available to authorized users.
A 78-year-old man presented with a 1-month history of exertional dyspnoea, anorexia, weight loss and night sweats. On physical examination the patient had a cachectic appearance and multiple 2‑ to 4‑cm-diameter skin lesions (Fig.  1a). Electrocardiography (Fig.  1b) showed ST-segment elevation in leads V 1 and V 2 and ST-segment depression from V 3 to V 6 with no dynamic changes in serial electrocardiograms. Transthoracic echocardiography revealed large heterogeneous masses adhered to the myocardium with no clear cleavage plane, an intermediate echogenicity and involving the right ventricle, the atrioventricular groove and the large vessels (Fig.  1c; Electronic Supplementary Material, videos 1–3). He was admitted and a skin biopsy was performed which was compatible with diffuse large B‑cell lymphoma.
Cardiac lymphoma usually occurs in the context of metastatic involvement and can manifest in a variety of ways, depending on the location of the masses [ 1, 2]. This patient had no acute myocardial infarction criteria [ 3]. We hypothesise that the ST changes were explained by the infiltration or displacement of the myocardium by the tumour, mimicking underlying myocardial infarction.

Conflict of interest

J.P. Guimarães, J. Trigo, F. Fonçalves and J.I. Moreira declare that they have no competing interests.
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://​creativecommons.​org/​licenses/​by/​4.​0/​), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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Netherlands Heart Journal

Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie en de Nederlandse Hartstichting. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...

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