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以急性心肌梗死和下肢动脉栓塞为表现的肺部肿瘤。

Lung tumor presenting with acute myocardial infarction and lower extremity arterial embolism.

机构信息

Department of Cardiology, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College), Wuhu, 241001, Anhui, People's Republic of China.

Department of Pathology, Wannan Medical College, Wuhu, 241002, Anhui, People's Republic of China.

出版信息

BMC Cardiovasc Disord. 2020 Nov 11;20(1):482. doi: 10.1186/s12872-020-01770-0.

Abstract

BACKGROUND

Lung tumor embolization leading to acute myocardial infarction (AMI) is rare. Previouscases of lung tumor embolization were reported in the coronary artery. We describe here a case of lung tumor embolization leading to the simultaneous occurrence of AMI and lower extremity arterial embolism.

CASE PRESENTATION

A 64-year-old patient was admitted to the emergency department complaining of chest pain and was diagnosed with AMI.An echocardiography showed a mass in the left atrium that was speculated to be a myxoma. An emergency coronary angiography found no evidence of atherosclerosis. On the second day of admission, the patient was diagnosed with lower extremity arterial embolism. Initially, we speculated that the left atrium myxoma caused an embolism resulting in the AMI and lower extremity arterial embolism.However, a lung tumor was the real cause of both conditions. Unfortunately, the patient abandoned treatment when he learned of his disease and died three days later after being discharged from the hospital.

CONCLUSIONS

Lung tumor embolism is an extremely rare cause of AMI. Even rarer is the case presented here, in which a lung tumor embolism caused AMI and lower extremity arterial embolism. Clinicians should recognize lung tumor embolism as a potential cause of AMI.

摘要

背景

肺肿瘤栓子导致急性心肌梗死(AMI)较为罕见。此前有肺肿瘤栓子报告于冠状动脉的病例。我们在此描述了一例肺肿瘤栓子导致 AMI 和下肢动脉栓塞同时发生的病例。

病例介绍

一名 64 岁患者因胸痛就诊于急诊科,并被诊断为 AMI。超声心动图显示左心房有一个肿块,推测为黏液瘤。紧急冠状动脉造影未发现动脉粥样硬化证据。入院第二天,患者被诊断为下肢动脉栓塞。起初,我们推测左心房黏液瘤引起栓子形成,导致 AMI 和下肢动脉栓塞。然而,真正的病因是肺肿瘤。不幸的是,当患者得知自己的病情后放弃了治疗,三天后出院后死亡。

结论

肺肿瘤栓塞是 AMI 的一种极其罕见的病因。更为罕见的是,本例中肺肿瘤栓塞导致 AMI 和下肢动脉栓塞。临床医生应将肺肿瘤栓塞视为 AMI 的潜在病因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d89/7659083/dcf1a72eb4f5/12872_2020_1770_Fig1_HTML.jpg

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