巨型左心房肌瘤伴严重肺动脉高压

US cardiology Pub Date : 2024-11-13 eCollection Date: 2024-01-01 DOI:10.15420/usc.2024.02
Preet Shaikh, Mario Rodriguez Rivera, Michael A Beal, Matthew R Schill, Amit Pawale, Jonathan D Moreno
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引用次数: 0

摘要

心脏肿瘤的病因有广泛的鉴别诊断。多学科团队的合作以及适当的多模态成像检查对患者的治疗至关重要。一名有大量吸烟史的 41 岁男子在过去一个月里出现腹胀、水肿和呼吸困难。在此之前,他曾出现过两次右上肢和左下肢麻痹,但都自行缓解。胸部计算机断层扫描(CT 扫描)显示,一个 8.5 厘米的肿块堵塞左心房并突出于二尖瓣。多模态成像(经胸超声心动图和心脏核磁共振成像)确诊为肌瘤。由于病情严重,血液动力学检查显示患者患有严重的肺动脉高压。患者接受了手术切除,症状完全缓解。心房肌瘤虽然罕见,但却是最常见的心脏良性肿瘤之一。及时优化和明确的手术治疗至关重要。
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Giant Left Atrial Myxoma Presenting with Severe Pulmonary Hypertension.

The etiology of cardiac tumors has a broad differential diagnosis. The use of a multidisciplinary team along with appropriate workup with multimodality imaging is critical for patient management. A 41-year-old man with a history of heavy tobacco use presented with abdominal distension, edema, and dyspnea for the past month. Prior to this presentation, he had experienced two episodes of right upper extremity and left lower extremity paresthesias that resolved spontaneously. A chest computed tomography (CT scan revealed an 8.5 cm mass that obliterated the left atrium and protruded across the mitral valve. Multimodal imaging (transthoracic echocardiography and cardiac MRI) confirmed a diagnosis of myxoma. Highlighting the severity of the presentation, hemodynamics revealed severe pulmonary hypertension. The patient underwent surgical resection with complete resolution of symptoms. Atrial myxomas are rare, but are among the most common type of benign cardiac tumors. Prompt optimization and definitive surgical management are critical.

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