Headaches, Heart Block, and a Heart Tumor: Unusual Presentation of Malignant Melanoma

Cardiac tumors may range from benign primary cardiac masses to malignant metastatic tumors. The constellation of systemic symptoms and presenting findings in metastatic cardiac tumors may be non-specific and may lead to non-cardiac testing before the diagnosis is confirmed with advanced cardiac imaging. We present a case of malignant melanoma with metastatic disease to the heart presenting with headaches, altered mental status, and complete heart block. A detailed history and dermatologic exam should be pursued in any case of cardiac tumor, as metastatic melanoma has a predilection for cardiac involvement. The prognosis remains poor independent of chemotherapy, immunotherapy, and surgical resection, especially with a higher burden of metastatic disease.