Complete Atrioventricular Block due to Cardiac Metastasis of Bronchogenic Carcinoma

A partial review of the literature indicates that the heart is not infrequently involved in patients who have malignant disease. The most common tumors metastasizing to the heart are bronchogenic carcinoma, breast carcinoma, malignant melanoma, and the group of hematopoietic malignant tumors. The clinical triad of myocardial insufficiency, cardiac arrhythmia, and pericardial effusion involving a previously normal heart should alert one to this possibility, especially in a patient with known malignant tumor. Complete atrioventricular block is a rather uncommon manifestation of metastatic cardiac tumor. A case is reported in which complete heart block appeared as the sole clinical manifestation of metastatic involvement of the heart by bronehogenic carcinoma. Necropsy revealed cardiac involvement by tumor to be virtually limited to the interventricular septum.