Mathew Roshan, Agrawal Naman, Aggarwal Praveen, Jamshed Nayer
Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India.
J Emerg Med. 2019 Nov;57(5):710-712. doi: 10.1016/j.jemermed.2019.06.006. Epub 2019 Sep 3.
Cardiac myxoma is the most common primary benign tumor of the heart and it has diverse clinical presentations. It is known to embolize into systemic circulation. However, presentation with complete occlusion of the aorta is uncommon.
We report an 18-year-old female who presented to the emergency department with features of acute bilateral limb ischemia. Arterial Doppler ultrasonography showed infrarenal aortic occlusion. A bedside cardiac ultrasound was done in the emergency department which clinched the diagnosis of atrial myxoma. Complete surgical excision of the tumor and subsequent histopathologic examination confirmed the diagnosis of atrial myxoma. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This report puts emphasis on the fact that atrial myxoma, though rare, may be considered as a source of embolism in patients presenting with acute limb ischemia. The importance of bedside ultrasonography for early diagnosis in such presentations is also highlighted.
心脏黏液瘤是最常见的原发性心脏良性肿瘤，临床表现多样。已知其可栓塞进入体循环。然而，出现主动脉完全闭塞的情况并不常见。
我们报告一名18岁女性，因急性双侧肢体缺血症状就诊于急诊科。动脉多普勒超声显示肾下主动脉闭塞。在急诊科进行了床旁心脏超声检查，确诊为心房黏液瘤。肿瘤完整手术切除及随后的组织病理学检查证实为心房黏液瘤。为什么急诊医生应该了解这个病例？：本报告强调了这样一个事实，即心房黏液瘤虽然罕见，但在出现急性肢体缺血的患者中可能被视为栓子来源。同时也突出了床旁超声检查在此类表现中早期诊断的重要性。
