Abstract
The incidence of non-Hodgkin lymphoma has increased over the past 10 years, particularly in association with human immunodeficiency virus (HIV) infection. Burkitt lymphoma is a highly aggressive non-Hodgkin lymphoma that involves the heart in up to a third of cases. This case describes an HIV-positive patient with cardiac involvement of Burkitt lymphoma who presented with atrial flutter and heart failure with pulmonary edema. Transthoracic echocardiography showed extensive heterogeneous lymphomatous infiltration of the heart (including the right atrium), with associated wall motion abnormalities. Within a day of starting chemotherapy, the patient had converted to normal sinus rhythm. His heart failure rapidly improved, and a repeat echocardiogram performed on day 5 of chemotherapy showed a significant reduction in myocardial tumor burden and improved cardiac function. This case demonstrates how echocardiography plays a significant role in diagnosis, management, and follow-up of lymphoma (in this case Burkitt) with cardiac involvement.