title: Ventricular tachycardia associated with radiation-induced cardiac sarcoma.
abstract: Cardiac tumors can lead to distinct electrocardiographic changes and ventricular arrhythmias. Benign and malignant cardiac tumors have been associated with ventricular tachycardia. When possible, benign tumors should be resected when ventricular arrhythmias are intractable. Chemotherapy can shrink malignant tumors and eliminate arrhythmias. We report the case of a 52-year-old woman with breast sarcoma whom we diagnosed with myocardial metastasis after she presented with palpitations. The initial electrocardiogram revealed sinus rhythm with new right bundle branch block and ST-segment elevation in the anterior precordial leads. During telemetry, hemodynamically stable, sustained ventricular tachycardia with right ventricular localization was detected. Images showed a myocardial mass in the right ventricular free wall. Amiodarone suppressed the arrhythmia. To our knowledge, this is the first report of ventricular tachycardia associated with radiation-induced undifferentiated sarcoma. We discuss the distinct electrocardiographic changes and ventricular arrhythmias that can be associated with cardiac tumors, and we review the relevant medical literature.
authors.forename: Elijah H
authors.initials: EH
authors.lastname: Beaty
authors.forename: Wassim
authors.initials: W
authors.lastname: Ballany
authors.forename: Richard G
authors.initials: RG
authors.lastname: Trohman
authors.forename: Christopher
authors.initials: C
authors.lastname: Madias
mesh_terms: D000638:Amiodarone / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000532:radiotherapy*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006338:Heart Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D011237:Predictive Value of Tests; D011878:Radiotherapy / Q000009:adverse effects; D012509:Sarcoma / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D000638:Amiodarone
keywords: Amiodarone/administration & dosage/adverse effects/therapeutic use; arrhythmias, cardiac/diagnosis; heart neoplasms/complications/radiotherapy/secondary; neoplasms, radiation-induced/therapy; tachycardia, ventricular/diagnosis/drug therapy/etiology/physiopathology/prevention & control