Strachinaru Mihai, Gazagnes Marie-Dominique, Mabiglia Chiara, Costescu Isabela
Dept. of Cardiology, Brugmann UH Brussels, Belgium.
Acta Cardiol. 2013 Apr;68(2):193-6. doi: 10.1080/ac.68.2.2967278.
Transoesophageal echocardiography is often recommended in the evaluation of cryptogenic stroke, especially in those patients with no or few risk factors. We report the case of 66-year-old male with a history of multiple ischaemic strokes, admitted to our stroke unit following the discovery of multiple and diffuse new ischaemic lesions on a cerebral magnetic resonance imaging. Transoesophageal echocardiography led to the discovery of a very small mass attached to the tissue fold between the left superior pulmonary vein and the left atrial appendage (often referred to as"coumadin ridge"). The three-dimensional acquisition allowed detailed characterization of this mass. No other source of emboli was detected.The mass was considered to be most likely a tumour and was probably the cause of the multiple strokes. Due to the already advanced neurological disease and the small dimensions of the mass surgery was considered inappropriate. The patient was initiated on oral anticoagulants. This case highlights the importance of three-dimensional ultrasound in the detection and evaluation of intracardiac masses.
经食管超声心动图常用于隐源性卒中的评估，尤其是在那些无危险因素或危险因素较少的患者中。我们报告了一例66岁男性，有多次缺血性卒中病史，在脑部磁共振成像发现多发弥漫性新缺血性病变后入住我们的卒中单元。经食管超声心动图检查发现一个非常小的肿块附着于左上肺静脉与左心耳之间的组织皱襞（常称为“华法林嵴”）。三维成像技术能够对该肿块进行详细的特征描述。未检测到其他栓子来源。该肿块最有可能是肿瘤，可能是多次卒中的病因。由于神经系统疾病已处于晚期且肿块较小，手术被认为不合适。患者开始口服抗凝剂治疗。该病例强调了三维超声在检测和评估心内肿块中的重要性。
