Department of Academic Cardiology, Hull and East Yorkshire Medical Research and Teaching Centre, Castle Hill Hospital, Kingston upon Hull, UK.
J Cardiovasc Med (Hagerstown). 2012 Nov;13(11):769-70. doi: 10.2459/JCM.0b013e32834917ed.
An 88-year-old lady was referred to our Heart Failure Clinic with a history of 'occasional' breathlessness. Electrocardiography showed sinus rhythm and no other major abnormalities and N-terminal pro-B-type natriuretic peptide (NT-proBNP) was normal. Transthoracic echocardiography showed a non-dilated left ventricle with good systolic function. A bright and well-circumscribed, echogenic mass appeared inside a mildly dilated left atrium, visible in both parasternal and apical views. A three-dimensional echocardiographic reconstruction showed no mass within the left atrium; however, an extracardiac mass impinging its posterior wall was seen. Suspicion of an intrathoracic tumour was raised and cardiac magnetic resonance showed a hiatus hernia immediately adjacent to the left atrium. Care must be taken when evaluating masses in or close to the heart.
一位 88 岁的女士因“偶尔”呼吸困难被转介到我们的心力衰竭诊所。心电图显示窦性节律，没有其他重大异常，N 末端 B 型利钠肽前体（NT-proBNP）正常。经胸超声心动图显示左心室不扩张，收缩功能良好。一个明亮且边界清晰、回声增强的肿块出现在轻度扩张的左心房内，在胸骨旁和心尖视图中均可见。三维超声心动图重建显示左心房内无肿块；然而，在后壁可见一个心脏外肿块撞击。提示存在胸腔内肿瘤，心脏磁共振显示紧邻左心房的膈疝。在评估心脏内或附近的肿块时必须小心。
