心脏肿瘤伪装成ST段抬高型心肌梗死1例报告及文献复习。

Journal of clinical cases & reports Pub Date : 2021-04-01 Epub Date: 2020-02-08
Kang Xiang, Prashant D Bhave, S Patrick Whalen, Matthew J Singleton
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引用次数: 0

摘要

心脏肿瘤是罕见的,原发肿瘤比继发肿瘤少得多。他们可以表现出多种症状,包括心源性休克、心律失常、心包填塞和全身栓塞。有病例报道的患者有心脏肿瘤表现为ST段升高。虽然肿瘤患者ST改变的确切病理生理机制尚不清楚,但目前提出的理论包括肿瘤栓塞冠状动脉、冠状动脉外压、心肌纤维拉伸、炎症反应以及坏死肿瘤组织向邻近心肌的电解质转移。我们报告一个病例,患者没有恶性肿瘤病史,但表现为咳嗽、呼吸短促、下肢水肿、心电图ST段抬高,并被发现左心室有上皮样肿瘤。本病例提高了人们对心肌梗死以外心电图ST段改变的广泛鉴别的认识,特别是在没有典型缺血症状的患者中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cardiac Tumor Masquerading as ST Elevation Myocardial Infarction: A Case Report and Literature Review.

Cardiac tumors are rare, with primary tumors much rarer than secondary. They can present with a variety of symptoms, including cardiogenic shock, arrhythmias, tamponade, and systemic embolism. There have been cases reported of patients having cardiac tumors presenting with ST elevations. While the exact pathophysiological mechanism for ST changes in patient with tumors is not known, proposed theories include tumor emboli to coronary artery, external compression of coronary arteries, stretching of cardiac muscle fibers, inflammatory reactions, and electrolyte transfer from necrotic tumor tissue to adjacent myocardium. We present a case in which the patient had no prior history of malignancy that are presented with cough, shortness of breath, lower extremity edema, ST elevation on electrocardiogram, and was found to have epithelioid tumor in his left ventricle. This case raises awareness of wide differential for ST changes on electrocardiogram besides myocardial infarction, especially in patients who do not present with classic ischemic symptoms.

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