Cardiology Department, HELPIS General Hospital, Athens, Greece.
Hellenic J Cardiol. 2011 Sep-Oct;52(5):462-5.
A large intracardiac mass is a rare condition and one with an extremely high risk of haemodynamic and embolic complications. Urgent surgical excision is the treatment of choice, and the histological examination reveals the exact nature of the mass, usually a myxoma or a thrombus. We present the case of an 80-year-old woman, with a history of atrial fibrillation, who was admitted because of a seriously impaired level of consciousness, and fever. A large cerebral infarct and a urinary tract infarction were diagnosed. On the transthoracic echocardiogram a giant, free-floating mass was detected in the left atrium, transiently obstructing the mitral valve orifice. Based on the features of the mass and patient's history, it was considered more likely to be a thrombus rather than a tumour. Given the patient's extremely unfavourable neurological status, cardiac surgery was considered to be contraindicated and the patient was administered unfractionated heparin intravenously. Unfortunately, after a few hours the patient suffered a cardiac arrest and died.
巨大心内肿块是一种罕见病症，且极易发生血液动力学和栓塞并发症。紧急外科切除是首选治疗方法，组织学检查可明确肿块的性质，通常为黏液瘤或血栓。我们报告了一位 80 岁女性病例，该患者有房颤病史，因严重意识障碍和发热而入院。诊断为大面积脑梗死和尿路梗死。经胸超声心动图显示左心房内有一个巨大的、可自由漂浮的肿块，短暂性阻塞二尖瓣口。根据肿块的特征和患者的病史，更倾向于认为它是血栓而不是肿瘤。鉴于患者神经功能严重不良，心脏手术被认为是禁忌的，给予患者静脉注射普通肝素。不幸的是，数小时后患者发生心脏骤停并死亡。
