Marchini Julio Flávio Meirelles, Rodrigues Alfredo Jose, Schmidt Andre
Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Clinica Medica, 2 Andar Seção de Cardiologia, Avenida Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, 14049-900, Brazil.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.06.2009.1944. Epub 2009 Sep 1.
Primary cardiac tumours are a rare occurrence in clinical practice. Mural or pedunculated thrombi are other infrequent findings. These are usually associated with underlying heart disease, present in the left atrium or occupying aneurysms in the ventricular wall, usually the apex. The case of a 33-year-old woman with a pedunculated cardiac mass not having these latter characteristics is reported. She had experienced dyspnoea and lower extremity oedema for 3 years on referral. Echocardiography revealed a mass emerging from the interventricular septum, and a myxoma was suspected. Heart surgery was performed and the findings were a thrombus and large extent of septal and apical mural fibrosis. An endoaneurysmorraphy was performed with exclusion of fibrotic walls from the ventricular cavity.
原发性心脏肿瘤在临床实践中较为罕见。壁性或带蒂血栓是其他不常见的发现。这些通常与潜在的心脏病有关,存在于左心房或占据心室壁的动脉瘤中,通常是心尖部。本文报告了一名33岁女性,其心脏有一个带蒂肿块,但不具备上述特征。转诊时,她已经出现呼吸困难和下肢水肿3年。超声心动图显示一个肿块从室间隔长出,怀疑是黏液瘤。进行了心脏手术,结果发现是一个血栓以及广泛的室间隔和心尖部壁性纤维化。进行了心室内动脉瘤修补术,将纤维化壁排除在心室腔外。