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表现为双侧肺栓塞的巨大右心房黏液瘤

Large Right Atrial Myxoma Presenting As Bilateral Pulmonary Embolism.

作者信息

Obagi Aref, Desai Dhaval, Mazahir Usman, Johnson David, Berger Lance

机构信息

Cardiology, Jersey Shore University Medical Center, Neptune, USA.

Cardiovascular Disease, Jersey Shore University Medical Center, Neptune, USA.

出版信息

Cureus. 2021 Jun 24;13(6):e15889. doi: 10.7759/cureus.15889. eCollection 2021 Jun.

Abstract

Myxoma is a rare benign tumor of the heart. Cardiac myxomas are the most common primary cardiac tumor in adults, commonly found within the left atrium. It can occur at any age and is more common in females than males. This case report aims to identify the clinical symptoms of cardiac myxoma, which can be life-threatening if neglected. Here, we present the case of a 30-year-old female with past smoking history. For the past three to four weeks before this hospitalization, her symptoms worsened including shortness of breath with exertion, dry cough, and pleuritic chest pain. Outpatient treatment with antibiotics and nebulizers did not relieve her symptoms. She went to the emergency room and underwent computed tomography of the chest with contrast showing bilateral lower lobe pulmonary emboli and a large mass in the right atrium. Intravenous unfractionated heparin was initiated. A transthoracic echocardiogram confirmed a 3.76 cm × 4.95 cm mass in the right atrium. The patient underwent surgical resection of the right atrial mass the following day and was discharged four days later in a stable condition. Pathology of the mass confirmed atrial myxoma.

摘要

黏液瘤是一种罕见的心脏良性肿瘤。心脏黏液瘤是成人最常见的原发性心脏肿瘤,通常位于左心房。它可发生于任何年龄,女性比男性更常见。本病例报告旨在确定心脏黏液瘤的临床症状,若被忽视可能危及生命。在此,我们呈现一例有吸烟史的30岁女性病例。在此次住院前的三到四周,她的症状加重,包括劳力性呼吸困难、干咳和胸膜炎性胸痛。门诊使用抗生素和雾化器治疗未能缓解她的症状。她前往急诊室,接受了胸部增强计算机断层扫描,显示双侧下叶肺栓塞以及右心房有一个大肿块。开始静脉注射普通肝素。经胸超声心动图证实右心房有一个3.76厘米×4.95厘米的肿块。患者于次日接受了右心房肿块的手术切除,四天后病情稳定出院。肿块病理证实为心房黏液瘤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0aba/8312776/337530881518/cureus-0013-00000015889-i01.jpg

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