case_images: PMC9244709_01
case_images: 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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case_images: 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 ).
case_images: 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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case_images: 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.
case_images: CMR showed a significant thickening of the left atrial wall.
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case_images: 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.
case_images: EMB taken from the left atrium showed hyperplasia of myocardial and fibrous tissue with localized irregular lymphoid-like cells.
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case_images: 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.