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Gepubliceerd in: Netherlands Heart Journal 9/2018

Open Access 23-07-2018 | Heart Beat

Swinging beats: transient heart block in cardiac lymphoma

Auteurs: J. W. Buikema, W. R. Goodyer, S. Koudstaal, J. van ’t Sant, P. W. Verheggen, E. A. de Vrey, B. J. de Smet

Gepubliceerd in: Netherlands Heart Journal | Uitgave 9/2018

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A 20-year-old man receiving chemotherapy for diffuse large B‑cell lymphoma with vascular involvement presented to the emergency room with dyspnoea. Chest radiography showed left-sided pleural effusion and an enlarged cardiac silhouette. Transthoracic echocardiography demonstrated large circumferential pericardial effusion with a so-called swinging heart with inflow obstruction (Fig. 1a). Remarkably, the patient was bradycardic and follow-up electrocardiography (ECG) revealed a junctional escape rhythm. Symptoms resolved after pericardiocentesis and drainage of 1,100 ml pericardial fluid containing B cells. Despite the drainage, a junctional rhythm persisted and after 24 h of continuous ECG the patient was discharged. Several weeks later, drainage was repeated for recurring pericardial effusion. ECG then showed an atrial flutter with 2:1 conduction. While in remission, follow-up electrocardiograms showed various ectopic atrial foci rhythms before returning to sinus rhythm 6 months later (Fig. 1b). Cardiac involvement of lymphomas is not uncommon. However, when patients develop transient blocks or arrhythmias this can be life-threatening and require additional vigilance during management [13].
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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Metagegevens
Titel
Swinging beats: transient heart block in cardiac lymphoma
Auteurs
J. W. Buikema
W. R. Goodyer
S. Koudstaal
J. van ’t Sant
P. W. Verheggen
E. A. de Vrey
B. J. de Smet
Publicatiedatum
23-07-2018
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Netherlands Heart Journal / Uitgave 9/2018
Print ISSN: 1568-5888
Elektronisch ISSN: 1876-6250
DOI
https://doi.org/10.1007/s12471-018-1135-z

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