Ogata Chinami, Nakatani Satoshi, Yasumura Yoshio, Kitakaze Masafumi, Yamagishi Masakazu
Division of Cardiovascular Medicine, National Cardiovascular Center, Fujishiro-dai 5-7-1, Suita, Osaka 565-8565.
J Cardiol. 2003 Jun;41(6):291-5.
A 64-year-old woman with hypertension presented with a left atrial giant mass during the treatment of congestive heart failure. She was admitted to our hospital for intensive treatment. Transesophageal echocardiography demonstrated a cauliflower-like, large (3 x 2 cm), mobile echogenic mass attached to the left atrial wall. There were no signs of systemic embolism. Anticoagulant therapy was started. Repeated echocardiography showed the mass was reduced gradually and had diminished on the 10th day. She remained asymptomatic during the anticoagulant therapy. The diagnosis was thrombus based on the response to treatment. Surgical removal should be considered for such a large thrombus, but the present case of giant thrombus was successfully treated by anticoagulants without systemic complication.
一名64岁高血压女性在治疗充血性心力衰竭期间出现左心房巨大肿物。她因强化治疗入住我院。经食管超声心动图显示一个菜花状、大(3×2厘米)、可移动的强回声肿物附着于左心房壁。无全身栓塞迹象。开始抗凝治疗。重复超声心动图显示肿物逐渐缩小,在第10天时已缩小。抗凝治疗期间她一直无症状。根据治疗反应诊断为血栓。对于如此大的血栓应考虑手术切除,但本例巨大血栓通过抗凝成功治疗,无全身并发症。