1例左心房黏液瘤患者的COVID-19死亡率

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摘要

患有合并症的人,特别是患有心血管疾病的人,因COVID-19而死亡的风险更高。在原发性心脏肿瘤中,心房黏液瘤是最常报道的,占所有病例的85%。大多数肿瘤发生在左心房,40 - 50%的患者伴有栓塞现象。在这个病例报告中,我们描述了一个35岁的西非裔妇女,她患有左心房黏液瘤,正在等待手术。她出现双心室心力衰竭的体征和症状,她的严重急性呼吸综合征冠状病毒-2 (SARS-CoV-2)检测结果为阴性。她在接受心脏手术前的医疗优化时病情恶化并死亡。尸检证实左房黏液瘤、心肌梗死、细菌性心内膜炎、充血性心力衰竭、COVID-19肺炎,肺拭子实时逆转录聚合酶链反应(rRT-PCR) SARS-CoV-2检测呈阳性。虽然不常见,心脏黏液瘤可能导致死亡,如果不及时处理。COVID-19可能使心房黏液瘤患者的治疗复杂化并造成死亡率。
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COVID-19 mortality in a patient with left atrial myxoma
Individuals with comorbid conditions, particularly those with cardiovascular diseases, are at a higher risk of mortality due to COVID-19. Among primary cardiac tumours, atrial myxoma is the most commonly reported, accounting for 85% of all cases. Most tumours occur in the left atrium with an associated embolic phenomenon in 40to 50% of patients. In this case report, we describe a 35-year-old woman of West African descent who had a left atrial myxoma and was waiting for surgery. She presented with signs and symptoms of biventricular heart failure, and her severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) test results were negative. She deteriorated and died while being optimized medically before cardiac surgery. Postmortem confirmed a left atrial myxoma, myocardial infarction, bacterial endocarditis, congestive cardiac failure, COVID-19 pneumonia, as well as a positive real-time Reverse Transcription Polymerase Chain Reaction (rRT-PCR) SARS-CoV-2 test on lung swabs. Though uncommon, cardiac myxomas may result in mortality if not managed promptly. COVID-19 may complicate the management of patients with atrial myxoma with mortality.
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