A fast-growing myxoma of the left atrium

Q3 Medicine
J. Benko, M. Péč, Marek Cingel, Jakub Jurica, T. Bolek, M. Mokáň, M. Samoš
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引用次数: 0

Abstract

Introduction: Myxoma of the left atrium is a less typical cause of mitral obstruction. If this develops, a flash pulmonary oedema can be the first manifestation. Case description: We present a case report of a 50-year-old woman who was admitted to our internal department because of dyspnoea. The patient overcame a stroke three years before the index hospitalisation with a negative transthoracic echocardiography. By anamnesis and physical examination, an exacerbation of COPD was assumed, and the patient was treated accordingly. As the patient showed numerous risk factors for heart failure with preserved ejection fraction, transthoracic echocardiography was performed. A large polypoid mass was found in the left atrium, which caused severe mitral obstruction. Subsequent transoesophageal echocardiography confirmed this finding. The patient underwent urgent cardiac surgery, and the tumour was successfully resected. A histological examination revealed a cardiac myxoma. After the cardiac surgery the patient felt well, and no recurrence of the tumour occurred. Conclusions: We provide a case report of a fast-growing myxoma that was incidentally found in a patient with dyspnoea. We highlight the fast growth rate of the tumour and the potential for misdiagnosed signs of pulmonary oedema caused by mitral obstruction.
左心房快速生长的肌瘤
导言:左心房肌瘤是导致二尖瓣阻塞的一个不太典型的原因。如果出现这种情况,可首先表现为闪电性肺水肿。病例描述我们报告了一例因呼吸困难而入住内科的 50 岁女性患者的病例。患者入院前三年曾中风,经胸超声心动图检查结果为阴性。通过询问病史和体格检查,我们推断患者为慢性阻塞性肺病加重,并对其进行了相应治疗。由于患者存在多种射血分数保留型心力衰竭的危险因素,因此对其进行了经胸超声心动图检查。发现左心房内有一个巨大的息肉样肿块,导致严重的二尖瓣梗阻。随后的经食道超声心动图证实了这一发现。患者接受了紧急心脏手术,肿瘤被成功切除。组织学检查显示为心脏肌瘤。心脏手术后,患者感觉良好,肿瘤也没有复发。结论:我们提供了一份关于一名呼吸困难患者偶然发现的快速生长肌瘤的病例报告。我们强调了肿瘤的快速生长速度以及二尖瓣阻塞引起肺水肿的潜在误诊迹象。
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来源期刊
CiteScore
2.10
自引率
0.00%
发文量
166
审稿时长
8 weeks
期刊介绍: The European Journal of Case Reports in Internal Medicine is an official journal of the European Federation of Internal Medicine (EFIM), representing 35 national societies from 33 European countries. The Journal''s mission is to promote the best medical practice and innovation in the field of acute and general medicine. It also provides a forum for internal medicine doctors where they can share new approaches with the aim of improving diagnostic and clinical skills in this field. EJCRIM welcomes high-quality case reports describing unusual or complex cases that an internist may encounter in everyday practice. The cases should either demonstrate the appropriateness of a diagnostic/therapeutic approach, describe a new procedure or maneuver, or show unusual manifestations of a disease or unexpected reactions. The Journal only accepts and publishes those case reports whose learning points provide new insight and/or contribute to advancing medical knowledge both in terms of diagnostics and therapeutic approaches. Case reports of medical errors, therefore, are also welcome as long as they provide innovative measures on how to prevent them in the current practice (Instructive Errors). The Journal may also consider brief and reasoned reports on issues relevant to the practice of Internal Medicine, as well as Abstracts submitted to the scientific meetings of acknowledged medical societies.
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