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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.

DOI:10.1093/ehjcr/ytab258
PMID:34377908
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8343455/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a38/8343455/3dde66accf44/ytab258f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a38/8343455/05d8c5e71e4d/ytab258f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a38/8343455/0d32bd6f58bf/ytab258f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a38/8343455/b0a3e03ea351/ytab258f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a38/8343455/d3081c48c694/ytab258f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a38/8343455/79182ccd2cc3/ytab258f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a38/8343455/fc09c797a2e4/ytab258f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a38/8343455/3dde66accf44/ytab258f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a38/8343455/05d8c5e71e4d/ytab258f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a38/8343455/0d32bd6f58bf/ytab258f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a38/8343455/b0a3e03ea351/ytab258f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a38/8343455/d3081c48c694/ytab258f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a38/8343455/79182ccd2cc3/ytab258f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a38/8343455/fc09c797a2e4/ytab258f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a38/8343455/3dde66accf44/ytab258f6.jpg

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