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由于左心房粘液瘤伪装成哮喘导致严重的功能性二尖瓣狭窄。

Severe functional mitral stenosis due to a left atrial myxoma masquerading as asthma.

机构信息

Department of Internal Medicine, MedStar Health, Baltimore, Maryland, USA

Heart and Vascular Institute, MedStar Union Memorial Hospital, Baltimore, Maryland, USA.

出版信息

BMJ Case Rep. 2020 Dec 17;13(12):e236876. doi: 10.1136/bcr-2020-236876.

Abstract

While cardiac myxomas are the most common primary cardiac tumours, their overall incidence remains rare. Most cases (90%) are sporadic and occur in the third-sixth decades of life with a female predominance and have a specific predilection for the left atrium (75%). While often asymptomatic, clinical presentations depend on the tumour size, architecture and location. Echocardiography remains the mainstay for diagnostic evaluation. Tumour resection is the only definitive treatment. Histopathology using H&E and immunohistochemical stains, such as calretinin and CD34, confirms the diagnosis. We present a case of a patient with reported history of asthma who presented with recurrent acute on chronic shortness of breath refractory to inhaler therapy, multiple outpatient visits and hospitalisations for 'asthma exacerbations'. After further evaluation, she was diagnosed with a left atrial myxoma attached to the inferior aspect of the intra-atrial septum complicated by severe functional mitral stenosis.

摘要

虽然心脏黏液瘤是最常见的原发性心脏肿瘤,但总体发病率仍然较低。大多数病例(90%)为散发性,发生在生命的第三至第六个十年,女性居多,对左心房有特定的偏好(75%)。虽然通常无症状,但临床表现取决于肿瘤的大小、结构和位置。超声心动图仍然是诊断评估的主要手段。肿瘤切除术是唯一的明确治疗方法。使用 H&E 和免疫组织化学染色(如钙视网膜蛋白和 CD34)的组织病理学检查可确诊。我们报告了一例有哮喘病史的患者,因反复急性加重的慢性呼吸困难,对吸入器治疗无反应,多次门诊和住院治疗“哮喘发作”。进一步评估后,诊断为左心房黏液瘤附着于房间隔下部,伴有严重的功能性二尖瓣狭窄。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f65b/7747612/9be4e3288587/bcr-2020-236876f01.jpg

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