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新冠肺炎患者中偶然发现的无症状心脏黏液瘤

Incidentally Detected Asymptomatic Cardiac Myxoma in a Patient With COVID-19.

作者信息

Shakerian Behnam, Jebelli Mohammad, Mandegar Mohammad Hossein

机构信息

Tehran University of Medical Sciences, Department of Cardiovascular Surgery, Tehran, Iran.

Shahrekord University of Medical Sciences, Department of Cardiovascular Surgery, Shahrekord, Iran.

出版信息

Clin Med Insights Case Rep. 2022 Mar 9;15:11795476221083115. doi: 10.1177/11795476221083115. eCollection 2022.

Abstract

Primary cardiac tumors, such as myxomas, are rare. About 75% of myxomas occur in the left atrium of the heart. Myxomas can have a broad clinical spectrum. The clinical presentation varies from asymptomatic to sudden cardiac death. Sometimes, a diagnosis is difficult. Cardiac myxoma can cause hemodynamic disturbances in the setting of pneumonia and hypercoagulable state in patients with Coronavirus disease 2019(COVID-19) and make treatment decisions difficult. We present a case of unusually huge left atrial mass discovered incidentally in a patient with COVID-19. Upon workup, an echocardiogram revealed an incidental 7 × 5 cm left atrial myxoma. Preoperatively, the patient was monitored closely in the ICU. After stabilization in the ICU, the patient was taken to surgery and the tumor was successfully removed. Pathohistological results after surgical removal of the tumor confirmed the diagnosis of cardiac myxoma. We consider our case extremely rare due to the asymptomatic course despite the large size of the tumor.

摘要

原发性心脏肿瘤,如黏液瘤,较为罕见。约75%的黏液瘤发生于心脏左心房。黏液瘤临床表现多样,从无症状到心源性猝死不等。有时,诊断颇具难度。心脏黏液瘤在2019冠状病毒病(COVID-19)患者中可导致肺炎及高凝状态下的血流动力学紊乱,进而使治疗决策变得困难。我们报告一例COVID-19患者偶然发现的异常巨大的左心房肿物。经检查,超声心动图显示偶然发现一个7×5厘米的左心房黏液瘤。术前,患者在重症监护病房(ICU)接受密切监测。在ICU病情稳定后,患者接受手术,肿瘤被成功切除。手术切除肿瘤后的病理组织学结果证实为心脏黏液瘤。鉴于肿瘤体积巨大但病程无症状,我们认为我们的病例极为罕见。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ddf/8915208/3bf78248de9f/10.1177_11795476221083115-fig1.jpg

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