62岁房颤患者左心房大量黏液瘤:1例报告及文献复习

Carma Karam, L. Legrand, Nicolas Mansenca, O. Dubourg
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引用次数: 0

摘要

在未选择的尸检患者中,心脏原发肿瘤的发生率在0.0017%到0.19%之间。四分之三的肿瘤是良性的,近一半的良性心脏肿瘤是黏液瘤。我们提出一个病例报告,62岁的高加索人没有已知的心血管危险因素提出在急诊室(ER)心悸。最初的心电图显示快速心房颤动约100 bpm,患者主诉最近用力时呼吸困难。进行心脏超声检查以排除瓣膜病或缺血性疾病,并测量左心房的大小。左心房有一个6厘米× 5厘米的巨大肿块。这名62岁的患者显示LAD轻度狭窄,需要手术切除肿瘤并行冠状动脉CT扫描。病人被送去做心脏手术。本病例提示及时手术治疗是安全的,手术死亡率低,长期预后良好。心脏超声是诊断和随访的首选方法。在大多数情况下,由于血管化的差异,超声造影可以区分心脏肿瘤、黏液瘤和血栓。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A VOLUMINOUS LEFT ATRIAL MYXOMA IN A 62-YEAR OLD MAN WITH ATRIAL FIBRILLATION: A CASE REPORT AND REVIEW OF THE LITERATURE
The incidence of primary tumors of the heart varies between 0.0017 and 0.19 percent in unselected patients at autopsy.Three of four tumors are benign and nearly half the benign heart tumors are myxomas. We present a case report of a 62-year-old caucasian man without known cardiovascular risk factors presented at the emergency room (ER) for palpitations. The initial EKG showed rapid atrial fibrillation around 100 bpm and the patient complained of a recent dyspnea at exertion. Cardiac ultrasound was performed to rule out valvular or ischemic disease and measure the size of the left atrium. It showed a voluminous mass of 6 cm x 5 cm in the left atrium. The surgical removal of the tumor was indicated and a CT scan of the coronary arteries was performed in this 62-year-old patient that showed mild stenosis on the LAD. The patient was sent to cardiac surgery. This case suggests  that  prompt surgical treatment was safe with a low operative mortality and good long term prognosis. Cardiac ultrasound was the method of choice for diagnosis and follow-up. Contrast echocardiography allowed differentiating between cardiac tumors, myxomas and thrombi in most cases due to the difference in vascularisation.
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