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心脏内肿物作为白塞病的初始心脏表现:手术前需谨慎考虑。

Intracardiac mass as initial cardiac manifestation of Behçet's disease: think before you cut.

作者信息

Leibowitz David, Korem Maya, Livovsky Dan M, Peleg Hagit, Chajek-Shaul Tova, Hiller Nurith

机构信息

Department of Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

出版信息

Echocardiography. 2014 Sep;31(8):E243-6. doi: 10.1111/echo.12653. Epub 2014 Jun 13.

Abstract

Behçet's disease (BD) is a chronic multisystemic inflammatory disorder. Cardiac abnormalities including intracardiac thrombi have been described in up to 16% of cases. The clinical presentation of cardiac complications in BD may include fever, dyspnea, chest pain, hemoptysis, and edema. We present 2 cases of patients who underwent surgical excision of intracardiac masses thought to be intracardiac malignancies. Further pathological and clinical evaluation established intracardiac inflammatory masses due to BD as the final diagnosis. As intracardiac masses may be the presenting manifestation of BD, it is crucial for echocardiographers to consider BD in the differential diagnosis. A careful history and physical exam looking for signs and symptoms of BD is critical before considering surgical excision of unexplained intracardiac masses. If the final diagnosis is BD anti-inflammatory therapy should be considered the basis of treatment.

摘要

白塞病(BD)是一种慢性多系统炎症性疾病。高达16%的病例中曾描述过包括心内血栓在内的心脏异常情况。白塞病中心脏并发症的临床表现可能包括发热、呼吸困难、胸痛、咯血和水肿。我们报告2例接受心内肿块手术切除的患者,这些肿块曾被认为是心内恶性肿瘤。进一步的病理和临床评估确定最终诊断为白塞病所致的心内炎性肿块。由于心内肿块可能是白塞病的首发表现,超声心动图检查人员在鉴别诊断中考虑白塞病至关重要。在考虑对不明原因的心内肿块进行手术切除之前,仔细询问病史并进行体格检查以寻找白塞病的体征和症状至关重要。如果最终诊断为白塞病,应考虑将抗炎治疗作为治疗基础。

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