Quick Fire Cases
soukaina SCADI, MD
Fellow
Hôpital Privé Jacques Cartier, France
soukaina SCADI, MD
Fellow
Hôpital Privé Jacques Cartier, France
Suzanne DUHAMEL, MD
Cardiologist
Institut Cardiovasculaire Paris Sud, France
Giuseppe TOTARO, MD, PhD
Fellow
Hôpital Privé Jacques Cartier, France
Gaetano Liccardo, MD
Fellow
Hôpital Privé Jacques Cartier, France
Alexandre Pfeffer, MD
Cardiologist
Lariboisiere Hospital, France
Jerome Garot, PhD
Head
ICPS - Massy, France
Though relatively rare, cardiac metastases represent a significant clinical challenge due to their impact on cardiac function and overall patient prognosis.
This case presents a rare and atypical presentation of negative troponin in a patient with metastatic cancer in the heart discovered following ventricular arrhythmia.
Diagnostic Techniques and Their Most Important Findings:
A 59 year-old man with lung cancer under treatment, was admitted for chest tightness and syncope with sustained ventricular tachycardia.
Echocardiogram showed anterolateral/anterior hypokinetic myocardium. Coronary angiogram was normal. CMR revealed a very inflammatory inhomogeneous anterior an anterolateral medial mid-wall mass (44 x 36 mm) adjacent to the lung carcinomatous mass, with a necrotic central core and very heterogeneous enhancement. Our patient had a poor short term prognosis, no additional treatment was proposed except medical treatment and palliative care.
Discussion: negative troponin, importance of CMR in diagnosis of cardiac masses, prognosis and treatment.
Learning Points from this Case:
To keep in mind the difficulty of a differential diagnosis of ventricular arrhythmia in patient with cancer under treatment and negative troponin, hence the importance of multimodality imaging, for diagnosis and management.
