Bartolomucci Francesco, Tito Antonio, Navarese Eliano Pio, Iacovelli Fortunato, Mele Marco, Larosa Claudio, Ciccone Marco Matteo, Cassese Mauro, Pepe Martino
Division of Cardiology, L. Bonomo Hospital, Andria (BT), Italy.
Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, University of Bari, School of Medicine, Policlinico, Bari, Italy.
Heart Surg Forum. 2017 Jun 30;20(3):E116-E118. doi: 10.1532/hsf.1607.
Primary cardiac tumors are a rare entity whose incidence in the general population ranges from 0.0017% to 0.28%. Myxomas represent nearly half of all primary benign cardiac tumors and they prevalently affect female patients. Embolic manifestation is rare with a reported incidence of 0.06%.We present the case of a 30-year-old male patient with acute anterolateral infarction caused by total occlusion of the left anterior descending artery as a consequence of a left atrial myxoma embolization. Urgent surgical resection of the mass didn't avoid early recurrence of atrial myxoma, whose second presentation was again myocardial infarction.This case alerts physicians to "unusual" myocardial infarction patients, when atherosclerotic pathogenesis appears unlikely. In these cases early echocardiographic evaluation should be mandatory and atrial myxoma should be considered among the possible causes. Complete surgical resection is the only effective therapeutic option to improve prognosis; the chance of tumor recurrence should dictate careful research for additional myxomas during surgery and stricter follow-up planning.
原发性心脏肿瘤是一种罕见的疾病，在普通人群中的发病率为0.0017%至0.28%。黏液瘤占所有原发性良性心脏肿瘤的近一半，且女性患者更为常见。栓塞表现罕见，报道的发生率为0.06%。我们报告一例30岁男性患者，因左心房黏液瘤栓塞导致左前降支完全闭塞，引发急性前壁心肌梗死。紧急手术切除肿块未能避免心房黏液瘤的早期复发，其再次表现为心肌梗死。该病例提醒医生，当动脉粥样硬化发病机制不太可能时，要警惕“不寻常”的心肌梗死患者。在这些情况下，早期超声心动图评估应成为必需，且心房黏液瘤应被视为可能的病因之一。完整的手术切除是改善预后的唯一有效治疗选择；肿瘤复发的可能性应促使在手术期间仔细检查是否存在其他黏液瘤，并制定更严格的随访计划。
