Heart of the Matter: Syncope as a Rare Presentation of Lung Cancer Invading the Heart.
Heart of the Matter: Syncope as a Rare Presentation of Lung Cancer Invading the Heart.
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DOI：
10.1177/23247096211053709
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发表时间：
2021-01
影响因子：
1.2
通讯作者：
Zeki AA
中科院分区：
文献类型：
--
作者：
Al-Juburi S;Rafizadeh S;Zeki AA
晕厥很常见，每年影响大约一百万美国人。尽管已记录了有关其病因的多种病理生理学机制，但神经心源性或血管迷走性晕厥是这些发作的最常见原因。其他不太受重视的病因包括各种心脏异常，其中结构性、电性或阻塞性紊乱导致流向大脑的血流暂时减少，从而导致短暂的意识丧失。心脏恶性肿瘤虽然罕见，但可通过破坏心脏传导装置或仅阻碍流经心室的血流而出现晕厥。心电图和超声心动图通常对识别这些异常非常有帮助。在这里，我们报告一例罕见的晚期浸润性肺鳞状细胞癌，表现为反复晕厥事件。癌症侵入心脏右心房，引起各种心律失常，导致心源性晕厥的罕见原因。我们还讨论了肺癌如何以亚临床方式出现，有时没有明显的呼吸道症状、明显的体检异常和/或胸片上的胸部影像学异常。
Syncope is common, affecting approximately 1 million Americans every year. Although multiple pathophysiological mechanisms regarding its etiology have been documented, neurocardiogenic or vasovagal syncope is the most common cause of these episodes. Other less appreciated etiologies include various cardiac abnormalities in which a structural, electrical, or obstructive disturbance leads to a temporary reduction in blood flow to the brain, resulting in transient loss of consciousness. Cardiac malignancies, while rare, can present with syncope by either disrupting the cardiac conduction apparatus or simply obstructing blood flow through the cardiac chambers. Electrocardiograms and echocardiography are often very helpful in identifying these abnormalities. Here, we report a rare case of late-stage invasive squamous cell carcinoma of the lung presenting with recurrent syncopal events. The cancer invaded the cardiac right atrium causing various dysrhythmias, leading to a very rare cause of cardiogenic syncope. We also discuss how lung cancer can present in a subclinical manner and at times without obvious respiratory symptoms, dramatic physical examination abnormalities, and/or thoracic imaging abnormalities on chest radiograph.