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The patient in this case had a number of risk factors that have been previously associated with twiddler's syndrome. © The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology.Background Cardiac metastasis of melanoma rarely causes heart failure symptoms and the recognition of cardiac involvement is in most cases first established post-mortem. Surgical removal might be considered in selected cases in patients with an inflow or outflow tract obstruction even though the survival remains poo
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