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一对左心房黏液瘤酷似左心耳血栓并导致一名年轻成年人缺血性卒中:病例报告

A pair of two atrial myxomas mimic thrombus in left atrial appendage and cause ischemic stroke in a young adult: a case report.

作者信息

Shahverdi Ehsan, Bolte Hendrik, Schneider Carsten, Lange Mathias

机构信息

Department of Cardiology, Rhythmology, Angiology and Intensive Care Medicine, Heart Center Osnabrueck, Hospital Osnabrueck, Westphalian Wilhelms University of Muenster, Osnabrueck, Germany.

Department of Radiology, Hospital Osnabrueck, Westphalian Wilhelms University of Muenster, Osnabrueck, Germany.

出版信息

Eur Heart J Case Rep. 2024 Nov 22;8(12):ytae615. doi: 10.1093/ehjcr/ytae615. eCollection 2024 Dec.

DOI:10.1093/ehjcr/ytae615
PMID:39691847
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11650382/
Abstract

BACKGROUND

Stroke is one of the leading causes of mortality and disability and can be rarely caused by cardiac myxoma.

CASE SUMMARY

Here, we report about a 56-year-old man who suffered from a stroke presented with acute dysarthria and left hemiparesis. Magnetic resonance imaging (MRI) of the brain revealed an acute stroke. Atrial fibrillation (AF) was assumed the cause of stroke. Because of contraindication to anticoagulation due to previous cerebral haemorrhage with rivaroxaban the patient was admitted to interventional occlusion of left atrial appendage. Echocardiography revealed two left atrial masses suggestive of atrial myxomas. The patient was transferred to remove the two myxomas operatively with simultaneous resection of left atrial appendage.

DISCUSSION

Atrial myxomas should be considered as a possible differential diagnosis of cardioembolic stroke. They should be managed early to prevent recurrent strokes.

摘要

背景

中风是导致死亡和残疾的主要原因之一,而心脏黏液瘤很少引发中风。

病例摘要

在此,我们报告一名56岁男性,因中风出现急性构音障碍和左侧偏瘫。脑部磁共振成像(MRI)显示为急性中风。房颤(AF)被认为是中风的病因。由于既往有脑出血病史且使用利伐沙班抗凝存在禁忌证,该患者接受了左心耳介入封堵术。超声心动图显示左心房有两个肿块,提示心房黏液瘤。患者被转至手术室切除这两个黏液瘤并同时切除左心耳。

讨论

心房黏液瘤应被视为心源性栓塞性中风可能的鉴别诊断。应尽早进行治疗以预防中风复发。

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本文引用的文献

1
Cardioembolic Stroke in Young: A Case of Atrial Myxoma Origin.年轻人的心源性栓塞性卒中:一例源于心房黏液瘤的病例
Cureus. 2022 Aug 11;14(8):e27890. doi: 10.7759/cureus.27890. eCollection 2022 Aug.
2
Atrial Myxoma Presenting as an Atypical Stroke in a Young Patient With a Recent COVID-19 Infection.一名近期感染新冠病毒的年轻患者,心房黏液瘤表现为非典型性中风
Cureus. 2022 Jun 28;14(6):e26407. doi: 10.7759/cureus.26407. eCollection 2022 Jun.
3
Left ventricular chordae tendinae myxoma causing stroke: A rare finding.左心室腱索黏液瘤导致中风:罕见发现。
Ann Card Anaesth. 2022 Jul-Sep;25(3):346-348. doi: 10.4103/aca.aca_19_21.
4
Cardiac Myxoma as a Rare Cause of an Ischemic Stroke of the Vertebrobasilar Territory in a Young Adult: A Case Report.心脏黏液瘤作为青年成人椎基底动脉供血区缺血性卒中的罕见病因:一例报告
Cureus. 2022 May 6;14(5):e24792. doi: 10.7759/cureus.24792. eCollection 2022 May.
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Left Atrial Thrombi Masquerading as Myxomas: Mini Case Series and Literature Review.伪装成黏液瘤的左心房血栓:小型病例系列及文献综述
CASE (Phila). 2020 May 6;4(4):252-259. doi: 10.1016/j.case.2020.03.009. eCollection 2020 Aug.
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Assessment of Cardiac Masses by Cardiac Magnetic Resonance Imaging: Histological Correlation and Clinical Outcomes.心脏磁共振成像评估心脏质量:组织学相关性和临床结局。
J Am Heart Assoc. 2019 Jan 8;8(1):e007829. doi: 10.1161/JAHA.117.007829.
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Neurological manifestations of atrial myxoma: A retrospective analysis.心房黏液瘤的神经学表现:一项回顾性分析。
Oncol Lett. 2018 Oct;16(4):4635-4639. doi: 10.3892/ol.2018.9218. Epub 2018 Jul 25.
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Cardiovascular magnetic resonance imaging for diagnosis and clinical management of suspected cardiac masses and tumours.心血管磁共振成像在疑似心脏肿块和肿瘤的诊断和临床管理中的应用。
Eur Heart J. 2011 Jun;32(12):1551-60. doi: 10.1093/eurheartj/ehr104. Epub 2011 Apr 15.
9
Surgical resection of atrial myxomas.心房黏液瘤的手术切除
AORN J. 2010 Oct;92(4):393-406, quiz 407-9. doi: 10.1016/j.aorn.2010.06.012.
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