Unusual Case of an Intramyocardial Tumor Presenting With a Ventricular Tachycardia

Abstract

A 64-year-old man with history of hyperlipidemia and type 2 diabetes mellitus presented with sudden onset of atypical chest pain and dyspnea at rest. He denied palpitations or dizziness. Examination revealed blood pressure of 132/ 81 mm Hg and a heart rate of 153 bpm. The ECG showed a wide-QRS-complex tachycardia compatible with a sustained monomorphic ventricular tachycardia ( Figure 1). An amiodarone drip was started, and the tachycardia abruptly terminated during the infusion. In the ECG performed shortly after (Figure 2), normal sinus rhythm with T-wave inversion (transient) in the lateral leads (I, aVL) was evident, probably related to cardiac memory phenomenon. There was no evidence of further arrhythmias while the patient was maintained on oral amiodarone treatment. A chest x-ray showed moderate cardiomegaly and an abnormal left mediastinal contour owing to a bulge in the surface of the left ventricle ( Figure 3A and 3B). A transthoracic echocardiogram was performed, demonstrating a normal-size left ventricle, with mild septal hypertrophy, normal systolic function of both ventricles, and no pericardial effusion. A coronary angiography excluded any occlusive disease but revealed a cardiac mass with multiple "feeding" collaterals from the left anterior

Interventricular septum mass presenting as a late acute coronary syndrome with ST-segment elevation: a case report

“… 6 , 7 Indeed, most cardiac masses are asymptomatic and are discovered during a routine examination or baseline echocardiography prior to chemotherapy, but our patient had no medical history of cancer. Nevertheless, some patients may present with dyspnoea, chest pain, 8 ventricular arrhythmia, 9 conduction disturbance 10 or, similar to our patient, mimic an acute myocardial ischaemic event. 6 , 7 Previous explanations have been proposed to better understand ACS presentation, including inflammation and potassium abnormalities inside and around the tumour and mechanical stress on fibres adjacent to the tumour mimicking ischaemic ECG patterns.…”

Ventricular Tachycardia Associated with Radiation-Induced Cardiac Sarcoma

“…We found only one report of a tumor smaller than 1.8 cm in its greatest dimension 27 -and, in most cases, the tumor was substan-tially larger (Table I). 9,25,26,[28][29][30][31][32][33][34][35][36][37] Metastatic melanomas, lymphomas, rhabdomyosarcomas, leiomyosarcomas, osteosarcomas, and oral, renal, and lung cancers have been associated with VT.…”