Bernal Torres Wikler, Vinasco Leidy A Giraldo, Gómez Juan Esteban, de León Juan D López Ponce
Departamento de Cardiología, Fundación Valle del Lili, Cra. 98 # 18-49, 760026 Cali, Colombia.
Facultad de Ciencias de la Salud, Universidad ICESI, Cl. 18 # 122-135, 760031 Cali, Colombia.
Eur Heart J Case Rep. 2024 Jan 23;8(3):ytae032. doi: 10.1093/ehjcr/ytae032. eCollection 2024 Mar.
Tumour-producing catecholamines arise in the adrenal medulla (pheochromocytomas), as well as in extra-adrenal chromaffin cells (paragangliomas). The origin can be from any location; however, it is very rare in the heart.
A 43-year-old woman with a history of arterial hypertension presented with dyspnoea on moderate exertion, New York Class Association (NYHA) functional classes III and IV, and oedema in the lower extremities. Medical and laboratory evaluation revealed an NT-proBNP of 6046 pg/mL, a left ventricular ejection fraction (LVEF) of 15%, longitudinal strain of -7%, and a mass located on the inner surface of the left atrioventricular groove. Surgical intervention was performed, and the tumour was resected. Pathological report showed an extra-adrenal paraganglioma without neoplastic involvement in the margins of the vena cava. After surgery, the patient showed clinical improvement with NYHA functional class I, LVEF of 56%, and longitudinal strain of -20% on transthoracic echocardiography 4 months after treatment.
Paragangliomas are tumours that are rarely found in the heart, and their diagnosis is difficult. However, early detection and treatment can improve the quality of life of affected patients.
产生肿瘤的儿茶酚胺类物质起源于肾上腺髓质(嗜铬细胞瘤)以及肾上腺外嗜铬细胞(副神经节瘤)。其起源可位于任何部位;然而,发生于心脏的情况极为罕见。
一名43岁有动脉高血压病史的女性,出现中度活动时呼吸困难,纽约心脏协会(NYHA)心功能分级为III级和IV级,下肢水肿。医学检查和实验室评估显示N末端B型利钠肽原(NT-proBNP)为6046 pg/mL,左心室射血分数(LVEF)为15%,纵向应变率为-7%,且在左房室沟内表面发现一个肿块。进行了手术干预,切除了肿瘤。病理报告显示为肾上腺外副神经节瘤,腔静脉边缘无肿瘤累及。术后,患者临床症状改善,治疗4个月后经胸超声心动图显示NYHA心功能分级为I级,LVEF为56%,纵向应变率为-20%。
副神经节瘤是罕见的心脏肿瘤,其诊断困难。然而,早期发现和治疗可改善受影响患者的生活质量。