心肌梗死后左心室心尖部肿块——并非总是血栓：诊断难题。
Left ventricular apical mass after myocardial infarction-not always a thrombus: a diagnostic dilemma.
机构信息
Cardiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.
Cardiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
出版信息
BMJ Case Rep. 2021 Oct 19;14(10):e245963. doi: 10.1136/bcr-2021-245963.
Myxomas arising from the left ventricle (LV) are extremely rare and can be easily mistaken for a thrombus. We report a case of a 35-year-old man who presented with an acute cerebrovascular accident, having had a prior history of an anterior wall myocardial infarction 2 years back with an echocardiographic evaluation showing mild LV systolic dysfunction. His present prothrombotic workup revealed hyperhomocystinaemia and elevated levels of factor VIII. Present echocardiography revealed a mass arising from a scarred LV wall. Considering the possibility of a thrombus, he was initially started on parenteral anticoagulation. Unfortunately, consequent echocardiogram evaluation showed no reduction in size of the LV mass hence surgical removal was done. Histopathological evaluation unveiled the mass to be a myxoma.
左心室（LV）黏液瘤极为罕见，容易误诊为血栓。我们报告了 1 例 35 岁男性，因急性脑血管意外就诊，2 年前有前壁心肌梗死病史，超声心动图检查显示轻度 LV 收缩功能障碍。其目前的血栓形成倾向检查显示高同型半胱氨酸血症和因子 VIII 水平升高。目前的超声心动图显示左心室壁疤痕处有一个肿块。考虑到血栓的可能性，他最初开始接受静脉内抗凝治疗。不幸的是，随后的超声心动图评估显示 LV 肿块大小没有缩小，因此进行了手术切除。组织病理学评估显示肿块为黏液瘤。
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