PMC9244709_01
Serial electrocardiographic strips upon patient admission. (A) Complete AVB before chemotherapy. (B) Still complete AVB on the second day after chemotherapy. (C) The complete AVB converted to second degree type 2 AVB on the sixth day after chemotherapy. (D) A first degree AVB on the eighteenth day. The initial electrocardiogram (ECG) of the patient during the chemotherapy.
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The initial electrocardiogram (ECG) showed a complete atrioventricular block (AVB) with a junctional rhythm ( Figure 1A ). ECG showed the atrioventricular block changed from third degree to second degree ( Figure 1B, C ) and finally to sinus rhythm cardiac ( Figure 1D ).
Transthoracic echocardiography showed a homogeneous isoechoic layer thickening of the endocardial surface of the left atrium across the entire left atrial wall.
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Transthoracic echocardiography ( Figure 2 ) shows a homogeneous isoechoic layer thickening of the endocardial surface of the left atrium across the entire left atrial wall with a thickness of approximately 1.06 cm, and the same changes were observed in the left auricle.
CMR showed a significant thickening of the left atrial wall.
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A cardiac magnetic resonance (CMR) examination was then carried out for the patient ( Figure 3 ), confirming a significant thickening of the left atrial wall with no enlargement of the left and right atrial chambers and a triple inversion recovery (IR) sequence showing a more homogeneous high signal with significant inhomogeneous enhancement on the delayed scan.
EMB taken from the left atrium showed hyperplasia of myocardial and fibrous tissue with localized irregular lymphoid-like cells.
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A histological examination of samples taken from the left atrium suggested ( Figure 4 ) hyperplasia of myocardial and fibrous tissue with localized irregular lymphoid-like cells.