由于缺乏获得卫生保健的机会而对类癌心脏病进行晚期诊断。

IF 3.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Aditi Sharma, Maria E Fierro, Stella Pak, Keerthi Thallapureddy, Moyosore Awobajo, Dawn Hui, Prince Otchere
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引用次数: 0

摘要

类癌综合征(CS)是由神经内分泌肿瘤释放血管活性物质引起的一组独特症状(Pandit et al., StatPearls, 2022)。神经内分泌肿瘤很罕见,年发病率为10万人中有2人(Ram等人,46:21- 27,2019)。高达50%的这些肿瘤患者会发展为类癌综合征,其特征是血清素水平升高引起的症状,最常见的症状包括疲劳、潮红、喘息和非特异性胃肠道症状,如腹泻和吸收不良(Pandit等人,StatPearls, 2022) (Fox等人)。[中文],90:1224-1228,2004)。随着时间的推移,类癌综合征患者可发展为类癌心脏病(CHD)。冠心病是指类癌肿瘤分泌的血管活性物质,如血清素、速激肽、前列腺素等,引起的心脏并发症。这些并发症最常见的包括瓣膜异常,但也可能表现为冠状动脉损伤、心律失常或直接心肌损伤(Ram等人,46:21- 27,2019)。虽然冠心病通常不是类癌综合征的初始特征,但它最终确实发生在高达70%的类癌肿瘤患者中(Ram等人,46:21- 27,2019)。, 146:65-73, 2021) (Macfie等。科学,222:665-669,2022)。由于进行性心力衰竭的风险,冠心病与显著的发病率和死亡率相关(Bober等)。农业学报,14:1179546820968101,2020)。在这个病例中,我们描述了一名35岁的西班牙裔妇女,她患有未确诊的类癌综合征超过10年,最终发展为严重的冠心病。在这个病人的情况下,我们强调缺乏获得医疗保健如何导致延迟诊断,适当的治疗,并在这个年轻的病人恶化的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Late-stage diagnosis of carcinoid heart disease due to lack of access to health care.

Late-stage diagnosis of carcinoid heart disease due to lack of access to health care.

Late-stage diagnosis of carcinoid heart disease due to lack of access to health care.

Late-stage diagnosis of carcinoid heart disease due to lack of access to health care.

Carcinoid syndrome (CS) is a unique constellation of symptoms caused by release of vasoactive substances from neuroendocrine tumors (Pandit et al., StatPearls, 2022). Neuroendocrine tumors are rare with an annual incidence of 2 in 100,000 people (Ram et al., 46:21-27, 2019). Up to 50% of patients with these tumors will develop carcinoid syndrome, which is characterized by symptoms caused by elevated levels of serotonin and most commonly include fatigue, flushing, wheezing, and non-specific gastrointestinal symptoms such as diarrhea and malabsorption (Pandit et al., StatPearls, 2022) (Fox et.al., 90:1224-1228, 2004). Over time, patients with carcinoid syndrome can develop carcinoid heart disease (CHD). CHD refers to the cardiac complications that occur when the vasoactive substances, such as serotonin, tachykinins, and prostaglandins, secreted from the carcinoid tumors. These complications most commonly include valvular abnormalities, but can also present as coronary artery damage, arrhythmias or direct myocardial injury (Ram et al., 46:21-27, 2019). While CHD is not typically an initial feature of carcinoid syndrome, it does eventually occur in up to 70% of patients with carcinoid tumors (Ram et al., 46:21-27, 2019) (Jin et.al., 146:65-73, 2021) (Macfie et.al., 224:665-669, 2022). CHD is associated with significant morbidity and mortality due to the risk of progressive heart failure (Bober et.al., 14:1179546820968101, 2020). In this case, we describe a 35-year-old Hispanic woman in South Texas with undiagnosed carcinoid syndrome for over 10 years that eventually progressed to severe CHD. In this patient's case, we emphasize how lack of access to healthcare resulted in delay of diagnosis, appropriate treatment, and worsened prognosis in this young patient.

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来源期刊
Cardio-oncology
Cardio-oncology Medicine-Cardiology and Cardiovascular Medicine
CiteScore
5.00
自引率
3.00%
发文量
17
审稿时长
7 weeks
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