{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T08:51:19Z","timestamp":1783759879268,"version":"3.55.0"},"reference-count":12,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,12,16]]},"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:p>A previously well 48-year-old man presented with presyncope and was found to be in complete heart block. Blood tests, echocardiography and coronary angiography were reported as normal, and a dual chamber permanent pacemaker was inserted. Six months later he re-presented with breathlessness. His chest X-ray showed cardiomegaly and echocardiography revealed a 4.4\u2009cm pericardial effusion. A CT thorax revealed a mass originating from the intra-atrial septum, extending into the right atrium and ventricle. There were multiple pulmonary lesions suspected to be metastases. Histology demonstrated high-grade B-cell lymphoma. He was treated with eight cycles of R-CHOP chemotherapy and showed good radiological and clinical improvement. Post-treatment echocardiography found severe left ventricular dysfunction with an ejection fraction of &lt;20%. Heart failure medical therapy was optimised and the pacemaker was upgraded to a resynchronisation device. A repeat scan 6\u2009months post device upgrade showed an improvement in ejection fraction to 45%\u201350%.<\/jats:p>","DOI":"10.1136\/bcr-2020-239356","type":"journal-article","created":{"date-parts":[[2021,1,12]],"date-time":"2021-01-12T18:43:15Z","timestamp":1610476995000},"page":"e239356","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Complete heart block as a herald sign for cardiac lymphoma"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6636-6174","authenticated-orcid":false,"given":"Holly P","family":"Morgan","sequence":"first","affiliation":[{"name":"Cardiology, Royal Gwent Hospital, Newport, South Wales, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muram","family":"El-Nayir","sequence":"additional","affiliation":[{"name":"Cardiology, Royal Gwent Hospital, Newport, South Wales, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Jenkins","sequence":"additional","affiliation":[{"name":"Haematology, Royal Gwent Hospital, Newport, South Wales, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip G","family":"Campbell","sequence":"additional","affiliation":[{"name":"Cardiology, Royal Gwent Hospital, Newport, South Wales, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,1,11]]},"reference":[{"key":"2025082713043274000_14.1.e239356.1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-005-1009-5"},{"key":"2025082713043274000_14.1.e239356.2","first-page":"270","article-title":"A \"low and slow\" approach to successful medical treatment of primary cardiac lymphoma","volume":"4","author":"Shah","year":"2014","journal-title":"Cardiovasc Diagn Ther"},{"key":"2025082713043274000_14.1.e239356.3","first-page":"1","article-title":"Primary cardiac lymphoma: lessons learned from a long survivor","volume":"2016","author":"Singh","year":"2016","journal-title":"Case Rep Cardiol"},{"key":"2025082713043274000_14.1.e239356.4","first-page":"2744","article-title":"Cardiac involvement in malignancies. 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