Cardiac Surgery Department, Palestine Medical Complex, Ramallah, Palestinian Territory.
Cardiology Department, Princess Alia Governmental Hospital, Hebron, Palestinian Territory.
J Cardiothorac Surg. 2024 Sep 20;19(1):540. doi: 10.1186/s13019-024-03056-4.
Myxomas are the most common primary benign heart tumors, typically found in the left atrium, with only 2-4% occurring in the right ventricle. Clinical presentations vary widely, including congestive heart failure and systemic embolic phenomena. This case report describes a rare right ventricular myxoma causing both inflow and outflow obstruction, presenting as progressive exertional dyspnea.
A 23-year-old male presented with two weeks of worsening exertional dyspnea. He was stable but tachypneic with a systolic murmur over the tricuspid area. Elevated erythrocyte sedimentation rate (ESR) and C-Reactive protein (CRP) were noted, while other lab tests were normal. Imaging, including echocardiography and chest tomography scan (CT) revealed a 4 × 3.8 × 4.6 cm mass in the right ventricle extending to the pulmonary trunk. Surgical resection via right ventriculotomy was performed, and histopathology confirmed myxoma. The patient recovered uneventfully.
Right ventricular myxomas, though rare, can cause significant obstruction and present with diverse symptoms. Timely diagnosis using imaging techniques like echocardiography is crucial. Surgical resection remains the definitive treatment, offering excellent outcomes and low recurrence rates. Early intervention is vital to prevent serious complications and ensure favorable patient prognosis.
黏液瘤是最常见的原发性良性心脏肿瘤,通常发生在左心房,仅有 2-4%发生在右心室。临床表现差异很大,包括充血性心力衰竭和全身栓塞现象。本病例报告描述了一种罕见的右心室黏液瘤,可导致流入道和流出道阻塞,表现为进行性运动性呼吸困难。
一名 23 岁男性因进行性运动性呼吸困难加重就诊,症状持续两周。他病情稳定但呼吸急促,三尖瓣区可闻及收缩期杂音。红细胞沉降率(ESR)和 C 反应蛋白(CRP)升高,其他实验室检查正常。影像学检查,包括超声心动图和胸部 CT 扫描,显示右心室有一个 4×3.8×4.6 厘米的肿块,延伸至肺动脉干。通过右心室切开术进行了手术切除,组织病理学证实为黏液瘤。患者恢复顺利。
尽管罕见,但右心室黏液瘤可引起严重阻塞,并表现出多种症状。及时使用超声心动图等影像学技术进行诊断至关重要。手术切除仍然是明确的治疗方法,提供了极好的结果和低复发率。早期干预对于预防严重并发症和确保患者预后良好至关重要。