A complete atrioventricular block secondary to myocardial metastases of lung cancer. A case report

A metastatic involvement of the heart is an uncommon phenomenon in clinical practice; it is more frequent in patients with end-stage disease and a wide tumor spread. The clinical diagnosis is very difficult because there are no early symptoms and most often, the presence of metastases in other sites, such as lung and lymph nodes, may determine a misunderstanding of the clinical picture. We report the case of a young male (44 years old) with a complete atrioventricular block due to metastatic myocardial involvement from a primary occult lung cancer. The first symptom of the disease was a syncopal spell. In spite of permanent pacemaker implantation, the patient died suddenly and unexpectedly after 3 days. Autopsy revealed an anaplastic carcinoma of the right lung hilus. The myocardium was invaded by numerous metastatic nodules, particularly in the interventricular septum and in the left ventricular wall.