Cardiac metastases are frequently asymptomatic but should be suspected in cancer patients presenting with sudden arrhythmias, signs of myocardial infarction, or congestive heart failure, especially if unresponsive to digitalis.
Cardiac metastases often remain clinically silent in cancer; leaves open prospective studies on detection thresholds in high-risk groups.
Among 250 consecutive autopsies done at the I. González Martínez Oncologic Hospital, there were 38 cases showing metastatic cardiac involvement. Of these, 20 showed diffuse and 18 localized or discrete nodular involvement. Nineteen cases were in the lymphoma—leukemia group; the others had a variety of primary lesions. The myocardium was most frequently involved. Only five cases showed signs and symptoms of cardiac disease attributable to the metastatic lesions. The most common cardiac finding was arrhythmias unresponsive to digitalis therapy. The electrocardiograms were of little help in diagnosing cardiac metastases. It was concluded that cardiac metastases should be suspected whenever sudden arrhythmias or signs of myocardial infarction appear or congestive heart failure ensues in a patient with cancer, especially if the disease is unresponsive to digitalis therapy, and that radiotherapy may be of value in relieving cardiac symptoms in such cases.
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Malaret et al. (1968) studied this question.
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