一例以应激试验期间晕厥为表现的巨大心脏内膜肉瘤病例报告。
A case report of a massive cardiac intimal sarcoma manifesting as syncope during a stress test.
作者信息
Rehman Mahin, El-Dabh Ashraf, Mandal Shobha, Sattur Sudhakar
机构信息
Department of Internal Medicine & Department of Cardiology, Heart and Vascular Center, Guthrie/Robert Packer Hospital, 1 Guthrie Square, Sayre, PA 18840, USA.
出版信息
Eur Heart J Case Rep. 2021 Jul 22;5(7):ytab258. doi: 10.1093/ehjcr/ytab258. eCollection 2021 Jul.
BACKGROUND
Syncope has many aetiologies but from a cardiac standpoint, if arrhythmogenic and ischaemic causes are not present, obstructive lesions should be considered. Cardiac spindle cell sarcomas are incredibly rare and difficult to cure.
CASE SUMMARY
A 62-year-old man presented for exercise stress test and had a syncopal episode on the treadmill. He was found to have a massive mass obstructing the transmitral flow. Patient was taken to the operating room and the mass was resected successfully. Histopathological confirmation revealed the mass to be a cardiac intimal sarcoma. Patient was initiated on a trial regimen of doxorubin, ifosfamide, and mesna.
DISCUSSION
Cardiac intimal sarcomas are aggressive cancers and are difficult to treat; there are no established treatment guidelines. They can lead to obstruction of blood flow through the cardiac chambers. From a cardiac perspective, without arrhythmogenic and ischaemic causes of syncope, obstructive lesions should be considered.
背景
晕厥有多种病因，但从心脏角度来看，如果不存在致心律失常和缺血性病因，则应考虑梗阻性病变。心脏梭形细胞肉瘤极其罕见且难以治愈。
病例摘要
一名62岁男性因运动负荷试验就诊，在跑步机上发生晕厥。发现有一个巨大肿物阻塞二尖瓣血流。患者被送往手术室，肿物被成功切除。组织病理学证实该肿物为心脏内膜肉瘤。患者开始接受多柔比星、异环磷酰胺和美司钠的试验性治疗方案。
讨论
心脏内膜肉瘤是侵袭性癌症，难以治疗；尚无既定的治疗指南。它们可导致血流通过心腔受阻。从心脏角度来看，在没有致心律失常和缺血性晕厥病因的情况下，应考虑梗阻性病变。
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