NEJM:心房粘液瘤-病例报道

2018-10-18 xing.T MedSci原创

心脏粘液瘤是成人中最常见的原发性心脏肿瘤类型,通常发生在左心房。如果病情得不到治疗,可能会出现充血性心力衰竭,栓塞性卒中和猝死等并发症。手术切除是有指征的治疗手段。

患者为一名健康的47岁女性,因劳力性呼吸困难、进行性疲劳和端坐呼吸加重6个月而就诊。

体格检查发现明显的窦性心动过速,可听见一种最初被认为是S3疾驰的异常心音,并且双腿水肿。胸部X线片显示肺静脉淤血。经胸超声心动图发现附着于房间隔的肿块,左心室部分脱垂阻塞舒张期间的二尖瓣流入道(如图A,箭头[LA表示左心房和LV左心室]所示)。



S2后的额外心音被认为是“肿瘤肿块”的特征。患者接受左心房肿块切除(测量5.7cm×4.3cm×5.0cm)(如图B所示),切除房间隔,并用牛心包补片重建。病理分析证实了房性粘液瘤的诊断

心房粘液瘤是成人中最常见的原发性心脏肿瘤类型,通常发生在左心房。如果病情得不到治疗,可能会出现充血性心力衰竭,栓塞性卒中和猝死等并发症。手术切除是有指征的治疗手段。

该患者术后超声心动图显示射血分数正常,并且没有穿过房间隔的血流。患者术后无明显异常,并出院回家。

原始出处:

M. Usman Ali,et al. Atrial Myxoma.N Engl J Med 2018; https://www.nejm.org/doi/full/10.1056/NEJMicm1802693

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    2018-10-19 sodoo
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    2018-10-18 smartxiuxiu

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