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Cardiac abnormalities in patients with diffuse malignant pleural mesothelioma
Author(s) -
Wadler Scott,
Chahinian Philippe,
Slater William,
Goldman Martin,
Mendelson David,
Holland James F.
Publication year - 1986
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19861215)58:12<2744::aid-cncr2820581232>3.0.co;2-9
Subject(s) - medicine , sinus tachycardia , mesothelioma , chest pain , cardiology , right bundle branch block , arrhythmogenic right ventricular dysplasia , atrial flutter , atrial fibrillation , radiology , electrocardiography , heart failure , pathology , cardiomyopathy
Many patients with diffuse malignant pleural mesothelioma have dyspnea or chest pain. Cardiac symptomatology is frequently difficult to differentiate from symptoms of pleuropulmonary disease. To better define the clinical characteristics of cardiac involvement in patients with mesothelioma, the electrocardiographic (EKG) and echocardiographic findings in 64 patients with biopsy‐proven malignant pleural mesothelioma were reviewed. A total of 19/64 (30%) patients had autopsy studies available for review. The EKG was abnormal in 55 patients (89%). Over half (60%) had an arrhythmia, including sinus tachycardia (42%), premature atrial and ventricular contractions (13%), atrial fibrillation (3%), and atrial flutter (1%). Over one third (37%) had a conduction abnormality, including bundle branch block (13%), hemiblock (8.5%), and incomplete right bundle branch block (13%). Echocardiography revealed a total of 13 patients with pericardial effusions, two with pericardial thickening, and one with an anterior sonolucent space. Of 19 autopsies, cardiac invasion was found in 14 (74%), with more than half to the pericardium and more than one quarter to the myocardium. It is concluded that: (1) clinical cardiac abnormalities occur in the great majority of patients with malignant pleural mesothelioma, (2) pathologic cardiac invasion occurs in the great majority of patients with pleural mesothelioma, and (3) the EKG and echocardiogram are helpful in differentiating cardiac involvement from progressive pulmonary disease in patients with pleural mesothelioma.