Kim Chang Hun, Je Hyung Gon, Ju Min Ho, Lee Chee-Hoon
Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Medical Research Institute of Pusan National University, Geumo-ro 20, Beomeo-ri, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea.
J Cardiothorac Surg. 2020 Jul 25;15(1):188. doi: 10.1186/s13019-020-01238-4.
Infective endocarditis and cardiac myxoma have common features including fever, systemic embolism and intra-cardiac masses. For this reason, these diseases are often misdiagnosed one for another despite proper imaging studies. Herein, we report a case of suspected infective endocarditis in a patient with acute stroke, fever and a mass adjacent to the mitral valve.
A 24-year-old male patient presented with recurrent fever and stroke. In view of a history of Cushing syndrome and a mobile mass in the left atrium, infective endocarditis was highly suspected. He was transferred for emergency cardiac surgical intervention. During surgery, intraoperative transesophageal echocardiography revealed a 7 cm mass attached to the interatrial septum. The mass was excised through right mini-thoracotomy and pathological examination confirmed the presence of a myxoma. Based on the above clinical findings and genetic analysis, the diagnosis of Carney complex was confirmed.
Infective endocarditis and cardiac myxoma have common features and can be misdiagnosed. If a young patient presenting with embolic stroke had a history of an endocrine neoplasm, Carney complex should be considered in the differential diagnosis of infective endocarditis.
感染性心内膜炎和心脏黏液瘤具有共同特征，包括发热、全身栓塞和心内肿块。因此，尽管进行了适当的影像学检查，这些疾病仍常被相互误诊。在此，我们报告一例急性中风、发热且二尖瓣附近有肿块的疑似感染性心内膜炎患者。
一名24岁男性患者出现反复发热和中风。鉴于其有库欣综合征病史且左心房有一个活动肿块，高度怀疑为感染性心内膜炎。他被转至医院进行紧急心脏手术干预。手术期间，术中经食管超声心动图显示一个7厘米的肿块附着于房间隔。通过右胸小切口切除肿块，病理检查证实为黏液瘤。基于上述临床发现和基因分析，确诊为卡尼综合征。
感染性心内膜炎和心脏黏液瘤有共同特征且可能被误诊。如果一名出现栓塞性中风的年轻患者有内分泌肿瘤病史，在感染性心内膜炎的鉴别诊断中应考虑卡尼综合征。
