Venkata Kasarabada Harish, Joshi Sudhir, Iyenger Sreenivasa, Desvin D V
Graded Specialist (Internal Medicine), INHS Kalyani, Visakhapatnam, India.
Senior Advisor (Cardiology), INHS Kalyani, Visakhapatnam, India.
Med J Armed Forces India. 2024 Dec;80(Suppl 1):S279-S283. doi: 10.1016/j.mjafi.2023.02.003. Epub 2023 Apr 10.
This case report deals with a case of stroke in young female patient who was later diagnosed to have left atrial tumor. This female patient in her late 20s presented with a history of 1 month of progressive postural giddiness (in upright position), which was followed by sudden onset right monoparesis. The patient arrived to the hospital with above mentioned complaints. Her National Institutes of Health Stroke Scale was 5, and on examination of cardiovascular system, she had a middiastolic murmur in upright position, which resolved in lying position. Her brain imaging noncontrast computerized tomography (NCCT), magnetic resonance imaging (MRI) revealed lacunar infarcts in multiple vascular territories. Her transthoracic echocardiography revealed a pedunculated mass of around 4 × 2 cm from inter atrial septum in left atrium. She was started on anticoagulation and was referred to a cardio thoracic, and vascular center for tumor excision and biopsy. She underwent successful tumor excision and histopathological examination of the resected mass revealed cardiac myxoma. Incidence of primary cardiac tumor is very less in realtime world data. An atrial myxoma presenting as acute stroke secondary to tumor embolization is extremely rare.
本病例报告涉及一名年轻女性患者的中风病例，该患者后来被诊断患有左心房肿瘤。这位快30岁的女性患者有1个月逐渐加重的体位性头晕（直立位时）病史，随后突然出现右半身轻瘫。患者带着上述症状前来医院就诊。她的美国国立卫生研究院卒中量表评分为5分，在心血管系统检查中，她在直立位时有舒张中期杂音，卧位时杂音消失。她的脑部影像学检查，非增强计算机断层扫描（NCCT）、磁共振成像（MRI）显示多个血管区域有腔隙性梗死。她的经胸超声心动图显示左心房房间隔有一个约4×2厘米的带蒂肿块。她开始接受抗凝治疗，并被转诊至心胸血管中心进行肿瘤切除和活检。她成功接受了肿瘤切除，切除肿块的组织病理学检查显示为心脏黏液瘤。在实际临床数据中，原发性心脏肿瘤的发病率非常低。心房黏液瘤表现为肿瘤栓塞继发急性中风极为罕见。
