Abstract
A 33-year-old male patient with no medical history presented to our emergency room for evaluation of progressive fatigue and dry cough. Chest x-ray revealed marked mediastinal and cardiac silhouette enlargement (Figure, A). Initial laboratory work was notable for a while blood cell count of 240.9 with 96% blasts. Peripheral blood smear was consistent with T-cell acute lymphoblastic leukemia. ECG revealed sinus tachycardia (heart rate, 126 bpm) with right-axis deviation and T-wave inversions throughout the precordial leads (Figure, B). Transthoracic echocardiogram demonstrated moderate focal left ventricular (LV) hypertrophy involving the mid and apical segments of the anterior and anterolateral walls with mildly reduced LV systolic function (40%–45%). LV posterior and septal wall thicknesses were 1.3 and …
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