Makkar Abhilash, Siraj Talhah, Zimmerman Stacy, Evans David, Landa Eric, Ganim Ismail, Sukpraprut-Braaten Suporn, Wagner Stephen D, Abhilash Aaliya
Internal Medicine, Unity Health - White County Medical Center, Searcy, USA.
Cardiology, Unity Health - White County Medical Center, Searcy, USA.
Cureus. 2021 Sep 10;13(9):e17872. doi: 10.7759/cureus.17872. eCollection 2021 Sep.
An echocardiogram is the most utilized imaging modality in the evaluation of patients with intracardiac masses. Of these, left atrial myxomas are the most common intracardiac tumors in which diagnostic recognition is important for appropriate management. This paper demonstrates a case study on how a proper physical exam along with proper imaging modalities may result in avoiding misdiagnosing patients with large sliding hiatal hernias who present with the complaint of chest pain. This case reveals a food bolus within a sliding hiatal hernia masquerading as an intracardiac mass. Cardiac masses can potentially be misdiagnosed using transthoracic echocardiography (TTE). While transthoracic echocardiography is uniquely resourceful as a point-of-care modality, it can be challenging to confirm whether an identified mass is attached to the myocardium or other cardiac or intrathoracic structures. The patient exhibited symptoms compatible with a cardiac mass. Primarily, the physical examination is vital in determining whether the patient should be referred for additional diagnostic modalities to assess for a cardiac mass. Auscultation of bowel sounds on the cardiac examination is consistent with a suspected hiatal hernia.
超声心动图是评估心内肿物患者时最常用的成像方式。其中，左房黏液瘤是最常见的心内肿瘤，对其进行诊断识别对于恰当治疗很重要。本文展示了一个病例研究，即恰当的体格检查及合适的成像方式如何能够避免误诊那些因胸痛前来就诊、患有大型滑动性食管裂孔疝的患者。该病例显示，滑动性食管裂孔疝内的食物团块伪装成了心内肿物。使用经胸超声心动图（TTE）有可能误诊心脏肿物。虽然经胸超声心动图作为一种床旁检查方式具有独特的优势，但要确认所发现的肿物是否附着于心肌或其他心脏或胸内结构可能具有挑战性。该患者表现出与心脏肿物相符的症状。首先，体格检查对于确定患者是否应转诊至其他诊断方式以评估心脏肿物至关重要。心脏检查时肠鸣音听诊结果与疑似食管裂孔疝相符。
