Nguyen Hien Quang, Chau Anh Ngoc Thi, Doan Khien Quoc, Tran Nhien Cam Thi
Radiology Department, Thu Duc city Hospital, Ho Chi Minh city, Vietnam.
Radiology Department, Tam Anh Hospital, Ho Chi Minh city, Vietnam.
Radiol Case Rep. 2023 Jun 21;18(9):3014-3019. doi: 10.1016/j.radcr.2023.05.069. eCollection 2023 Sep.
Atrial myxoma is the most common benign cardiac tumor, which can present with diverse symptoms. Systemic embolism is a frequent complication, affecting up to one-third of cases and frequently involving cerebral arteries. However, cardiac myxoma-induced myocardial infarction (MI) is rare. We report a case of a 56-year-old man presenting with predominant neurological symptoms and an unexplained elevation of hs-Trop T without clinical signs of acute MI. Computerized tomography of the head showed no acute lesions, but subsequent magnetic resonance imaging (MRI) revealed multiple small ischemic lesions and old microhemorrhage foci. A comprehensive cardiovascular investigation was performed. Ultrasonography revealed a left atrial mass. Cardiac MRI confirmed the mass was an atrial myxoma, and showed many old infarctions and scarring lesions in the cardiac muscle. The patient underwent tumor resection, but residual motor-neurological deficits were observed. This case emphasizes the importance of cardiac MRI in the diagnosis of multiple focal infarctions attributed to coronary embolism.
心房黏液瘤是最常见的心脏良性肿瘤,可表现出多种症状。系统性栓塞是一种常见并发症,高达三分之一的病例会出现,且常累及脑动脉。然而,心脏黏液瘤诱发的心肌梗死(MI)很罕见。我们报告一例56岁男性病例,其主要表现为神经症状,高敏肌钙蛋白T(hs-Trop T) unexplained升高且无急性心肌梗死的临床体征。头部计算机断层扫描未显示急性病变,但随后的磁共振成像(MRI)显示有多个小的缺血性病变和陈旧性微出血灶。进行了全面的心血管检查。超声心动图显示左心房有肿物。心脏MRI证实该肿物为心房黏液瘤,并显示心肌中有许多陈旧性梗死和瘢痕病变。患者接受了肿瘤切除术,但仍观察到残留的运动神经功能缺损。该病例强调了心脏MRI在诊断由冠状动脉栓塞引起的多发性局灶性梗死中的重要性。 (注:原文中“unexplained elevation of hs-Trop T”表述似乎不完整,可能存在遗漏信息,翻译时保留原文状态。)