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August 18, 1978

Reversible Heart Block in Acute Leukemia

Author Affiliations

From the Departments of Medicine (Drs Maguire, Burns, and Brown) and Radiology (Dr Tewfik), University of Iowa College of Medicine, Iowa City.

JAMA. 1978;240(7):668-669. doi:10.1001/jama.1978.03290070070022

INVOLVEMENT of the heart or pericardium in leukemia is a common finding in postmortem studies, with an incidence varying between 30% and 37%.1 Despite this high frequency, little morbidity or mortality is usually produced. Pericarditis, cardiomegaly, congestive heart failure, or ECG changes develop only occasionally. The ECG changes, including tachycardia, ST-T wave, and voltage changes are usually of a nonspecific nature2-4 and asymptomatic. Heart block has rarely been reported and is usually not symptomatic.4-7 However, high-grade heart block may be fatal if untreated.5,6 The cases reported by Blotner and Sosman1 in 1944 and by Habel7 in 1973 suggest that it may respond to radiotherapy. We report the case of an adult with erythroleukemia in whom symptomatic seconddegree heart block developed, which responded promptly to a single dose of radiation and ultimately had all evidence of conduction system disturbance resolve.

Report of a Case  A