Department of Anesthesiology, University of Nebraska Medical Center, Omaha, NE.
Department of Anesthesiology, University of Nebraska Medical Center, Omaha, NE.
J Cardiothorac Vasc Anesth. 2019 Aug;33(8):2351-2355. doi: 10.1053/j.jvca.2019.03.002. Epub 2019 Mar 8.
A 44-year-old woman was transferred to the authors' institution in cardiogenic shock secondary to a presumed viral myocarditis and subsequently was placed on venoarterial extracorporeal membrane oxygenation. Transthoracic echocardiography revealed a large right atrial mass of unknown etiology and moderate pericardial effusion. The patient was taken to the operating room for surgical removal of the right atrial mass. Intraoperative transesophageal echocardiography demonstrated cardiac tamponade with complete invagination of the right atrium. Surgical evacuation of the pericardial effusion reverted the right atrium, with no further evidence of the right atrial mass, and no mass was discovered after right atriotomy, indicating that the right atrial "mass" was likely the result of complete inversion of the right atrium in the setting of cardiac tamponade.
一位 44 岁女性因疑似病毒性心肌炎导致心源性休克转入作者所在机构，并随后接受了静脉-动脉体外膜肺氧合治疗。经胸超声心动图显示，右心房内有一不明原因的巨大肿块，且中等量心包积液。患者被送入手术室，行右心房肿块切除术。术中经食管超声心动图显示心脏压塞，右心房完全内陷。行心包积液引流术，右心房恢复正常，未见右心房肿块进一步表现，右心房切开后也未发现肿块，提示右心房“肿块”可能是心脏压塞时右心房完全内陷的结果。
