Mesothelioma of the atrioventricular node

Our plain-English summary of Mesothelioma of the atrioventricular node, by K. Nishida, G. Kamijima, T. Nagayama (British Heart Journal, 1985).

The study

• Authors: K. Nishida, G. Kamijima, T. Nagayama
• Journal: British Heart Journal
• Published: 1985;53(4):468-70
• Type of article: Case report
• Cited by: 18 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

A patient with Mobitz type 2 heart block caused by a mesothelioma of the atrioventricular node died of a subarachnoid haemorrhage at the age of 33 two years after implantation of a permanent pacemaker. Mesothelioma of the atrioventricular node is rare, and reported cases have all been diagnosed post mortem. Mesothelioma of the atrioventricular node should be considered in the differential diagnosis of heart block in children or young adults. This is the first case to be reported in Japan.

In plain English

This case report from Toho University School of Medicine in Tokyo described one patient. A 31 year old man was admitted to hospital with poor appetite and was diagnosed with alcoholic cirrhosis. At night his heart rate fell to 30 beats per minute, and an electrocardiogram showed 2:1 atrioventricular block, a disturbance of the heart's rhythm. A permanent pacemaker was implanted four weeks later. A year after that, the patient was readmitted with sudden headache and vomiting. A subarachnoid haemorrhage (bleeding around the brain) from a ruptured aneurysm was diagnosed, and the patient died on the ninth day. Examination after death found a small, ill defined tumour about 1 cm across in the atrioventricular node of the heart, which the authors described as a benign, so called mesothelioma. The authors noted that the heart block might have been incidental, because moderate coronary atherosclerosis was also found. They concluded that this tumour should be considered in children or young adults with heart block. The article does not mention asbestos.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient)
• Who was studied: One 31 year old man treated at Toho University School of Medicine, Tokyo, Japan; the authors state it is the first such case reported in Japan
• Exposure: None reported. The article does not mention asbestos or any other exposure. The tumour described is a benign tumour of the heart's atrioventricular node that the authors call a "so called mesothelioma".
• Main results:
  • The patient's electrocardiogram showed 2:1 atrioventricular block, after his heart rate fell to 30 beats/min at night
  • In the patient's heart recordings the HV interval was normal (30 ms) and the AH interval was prolonged (150 ms)
  • A permanent pacemaker was implanted four weeks later
  • A year later the patient had a subarachnoid haemorrhage from a ruptured aneurysm and died on the ninth day after admission
  • At necropsy, a tumour approximately 1 cm in diameter was found in the atrioventricular node
  • On microscopic examination the tumour was benign, a so called mesothelioma
• The authors' conclusion: The authors concluded that mesothelioma of the atrioventricular node should be considered in the differential diagnosis of heart block in children or young adults. They did not consider permanent pacemaker implantation lifesaving, because patients usually die of ventricular tachyarrhythmias.
• Limitations the authors state:
  • The authors state that the heart block may have been incidental in this patient, because moderate coronary atherosclerosis was found at necropsy
  • The authors state that the relation between cerebrovascular accident and atrioventricular node mesothelioma is unknown

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma, Differential Diagnosis.

Related studies

• "Mesothelioma of the atrioventricular node" with long-standing complete heart block. Report of a case — I.R. Wanless, B.W. Mielke, et al. (1975)
• Mesothelioma of the atrioventricular node and congenital complete heart block — R. Subramanian, B. Flygenring (1989)
• Congenital polycystic tumor of the atrioventricular node (endodermal heterotopia, mesothelioma): a histogenetic appraisal with evidence for its endodermal origin — G. Fine, U. Raju (1987)
• Corpora amylacea in mesothelioma of the atrioventricular node — R. David, Y. Hiss (1978)
• Primary mesothelioma of atrioventricular node: cause of sudden death — E.H. Hemsted (1986)
• Synovial sarcoma of the heart arising from a so-called mesothelioma of the atrio-ventricular node — E.A. Sheffield, B. Corrin, et al. (1988)

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