Buksa Marko, Gerc Vjekoslav, Dilic Mirza, Loza Vesna, Naser Nabil, Sokolovic Sekib, Hodzic Enisa, Brdjanovic Snjezana, Kulic Mehmed
Clinic of Heart Disease, Clinical Center of University of Sarajevo, Bosnia and Herzegovina.
Med Arh. 2009;63(6):320-2.
Atrial myxomas are the most frequent benign tumors of the heart. Left atrial myxomas are about 3-4 times more frequent then right. Clinical findings reveal atrioventricular obstruction symptoms and signs, symptoms and signs of peripheral arteries or pulmonary artery embolisation and/or nonspecific symptoms.
Review of atrial myxomas diagnosed at the Clinic of Cardiology in 20 years period and analysis of clinical characteristics, transthoracic echocardiographic (TTE), transesophageal echocardiographic (TEE), and M-mod echophonographic findings.
TTE is performed in all, but TEE in 16 patients. Simultaneous M-mod echophonocardiographic examination were performed in 11 patients, when optional equipment was applicable.
We found 24 atrial myxomas: 19 (79.2%) in left and 5 (20.810%) in right atrium. 21(87.5%) patients had some of the symptoms, but 3 (12.5%) were asymptomatic. TTE was performed in all patients, but we found 1 (2.4%) false negative result. TEE was performed in 14 (58.3%) patients. Echophonocardiographic recordings showed early diastolic tumor "plop" in 10 patients and unusual late diastolic tumor "plop" in one right atrial myxoma, which has not yet been described.
TTE is a reliable method in diagnosis of atrial myxomas, but not in all cases, while TEE has been found as always reliable. Echophonocardiographic recording is useful for confirmation and understanding of auscultatory finding when applicable.
心房黏液瘤是最常见的心脏良性肿瘤。左心房黏液瘤的发病率约为右心房的3 - 4倍。临床表现为房室梗阻症状和体征、外周动脉或肺动脉栓塞的症状和体征及/或非特异性症状。
回顾20年间在心脏病诊所诊断的心房黏液瘤,并分析其临床特征、经胸超声心动图(TTE)、经食管超声心动图(TEE)及M型超声心动图检查结果。
所有患者均进行TTE检查,16例患者进行TEE检查。11例患者在有可选设备时同时进行了M型超声心动图检查。
我们共发现24例心房黏液瘤:19例(79.2%)位于左心房,5例(20.8%)位于右心房。21例(87.5%)患者有某些症状,但3例(12.5%)无症状。所有患者均进行了TTE检查,但发现1例(2.4%)假阴性结果。14例(58.3%)患者进行了TEE检查。超声心动图记录显示,10例患者出现舒张早期肿瘤“扑通”声,1例右心房黏液瘤出现不寻常的舒张晚期肿瘤“扑通”声,此情况尚未见报道。
TTE是诊断心房黏液瘤的可靠方法,但并非在所有病例中都如此,而TEE一直被认为是可靠的。超声心动图记录在适用时有助于证实和理解听诊结果。