Hematoma of the interatrial septum associated with complete atrioventricular block

A 70-year-old man who had been treated for tongue cancer began to suffer from repeated syncopal attacks. His electrocardiogram indicated complete atrioventricular block. A permanent pacemaker was implanted. He was well for about 2 years after which time he developed dyspnea, suffered from general fatigue, and then suddenly died. A postmortem examination revealed a hematoma approximately 4 x 4. cm in size in the interatrial septum, connected to a noncoronary sinus and rupture of the noncoronary leaflet, which compressed the tricuspid and aortic valves. This hematoma might have been related to the conduction disturbance caused by destructive compression on the conduction system, and his death by the rupture of the noncoronary leaflet.