Pineda Andrés M, Mihos Christos G, Nascimento Francisco O, Santana Orlando, Lamelas Joseph, Beohar Nirat
Tex Heart Inst J. 2015 Dec 1;42(6):565-8. doi: 10.14503/THIJ-14-4619. eCollection 2015 Dec.
Systemic embolization from a primary cardiac tumor is a relatively frequent presentation. However, an acute myocardial infarction due to coronary embolization is rarely seen. We offer an unusual case of a 50-year-old man who presented with severe angina and was diagnosed with an inferolateral ST-segment-elevation myocardial infarction. Aside from otherwise healthy coronary arteries, his coronary angiogram revealed an acute occlusion of the first obtuse marginal branch, which was treated with balloon angioplasty. Because no residual plaque or dissection was found after the angioplasty, an embolic source was suspected. An echocardiogram then revealed a large mobile left atrial myxoma prolapsing into the left ventricle, so the patient underwent minimally invasive resection. Detailed pathologic examination of the myxoma revealed a concomitant high-grade B-cell lymphoma.
原发性心脏肿瘤引起的全身栓塞是一种相对常见的表现。然而，冠状动脉栓塞导致的急性心肌梗死却很少见。我们报告一例不寻常的病例，一名50岁男性，表现为严重心绞痛，被诊断为下侧壁ST段抬高型心肌梗死。除冠状动脉正常外，他的冠状动脉造影显示第一钝缘支急性闭塞，经球囊血管成形术治疗。血管成形术后未发现残余斑块或夹层，因此怀疑有栓子来源。随后的超声心动图显示一个巨大的可移动左心房黏液瘤突入左心室，于是患者接受了微创切除术。对黏液瘤的详细病理检查发现同时存在高级别B细胞淋巴瘤。
