Orban Marek, Tousek Petr, Becker Ingrid, Augustin Norbert, Firschke Christian
Deutsches Herzzentrum, Technische Universität München, Germany.
Int J Cardiovasc Imaging. 2004 Feb;20(1):47-51. doi: 10.1023/b:caim.0000013161.51607.cd.
Acute myocardial infarction is predominantly caused by coronary artery atherosclerotic plaque rupture and subsequent occlusive thrombus formation. The recognition of less common causes of acute myocardial infarction is important because they may require a different treatment strategy. We report a patient with acute myocardial infarction without any angiographic evidence of coronary atherosclerosis and a left atrial mass detected on echocardiography. Therefore, coronary embolism from intracardiac thrombus or tumor was suspected. No additional manifestations of a potential tumor were found on thoracic, abdominal and cranial computed tomography. During subsequent cardiac surgery, a large tumor could be in toto resected and was diagnosed as a highly malignant leiomyosarcoma on histopathological evaluation.
急性心肌梗死主要由冠状动脉粥样硬化斑块破裂及随后的闭塞性血栓形成所致。认识急性心肌梗死的少见病因很重要,因为它们可能需要不同的治疗策略。我们报告1例急性心肌梗死患者,其冠状动脉造影未发现任何动脉粥样硬化证据,超声心动图检查发现左心房有一肿块。因此,怀疑为心内血栓或肿瘤导致的冠状动脉栓塞。胸部、腹部及头颅计算机断层扫描未发现潜在肿瘤的其他表现。在随后的心脏手术中,完整切除了一个大肿瘤,组织病理学评估诊断为高恶性平滑肌肉瘤。