Cardiac Arrhythmias and Mesothelioma

There are a number of conditions that can contribute to cardiac arrhythmias in mesothelioma patients.  Arrhythmias are rapid atypical heartbeats which lose the characteristic patterns observed in the normal electrocardiogram (EKG). In mesothelioma, primary cardiac tumors of the heart (pericardial mesothelioma) or in most cases the spread of mesothelioma to the cardiac silhouette, can be responsible for arrhythmias.   The AV (atrial ventricular) node is composed of specialized tissues located between the atrium and ventricle.  The purpose of the av node is to set cardiac rhythm.  When malignancy impinges upon these tissues, arrhythmias can develop.  Common presenting symptoms are similar to those of congestive heart failure: cardiac and pleural effusions, shortness of breath and extreme fatigue.  Pulse will be irregular and in most cases rapid, greater than 100 beats per minute.

Surgery and the formation of scar tissue can damage this sensitive tissue following and EPP or PD.  These complications are described in papers reporting on large series of patients who have undergone this surgery.  In the immediate post operative period the major causes of arrhythmias usually reported are  incisional pain, hypovolemia due to blood loss and respiratory insufficiency due to anemia.

Tumor cells secrete substances not well understood that cause night sweats, fevers, anemia and sometimes a condition referred to as paraneoplastic syndrome.  Paraneoplastic syndrome can result in electrolyte imbalances and the heart muscle is sensitive to changes in electrolytes.

In most cases where we observe normal rhythm but rapid pulse, the cause is anemia.  In patients with cancer we describe a condition referred to as anemia of chronic disease.  In this group of patients we can transfuse regularly but the only true correction of this condition would be instituting effective chemotherapy. Thryoid dysfunction can also result in arrhythmias.

~Mary Hesdorffer, NP