移动性乳头状纤维弹性瘤通过左主干闭塞导致严重胸痛。
Mobile Papillary Fibroelastoma Leading to Severe Chest Pain via Left Main Occlusion.
作者信息
Ramirez Ariana Y, Kashuba-Shanahan Kevin M, Cavallaro Joseph A, Fentanes Emilio
机构信息
Department of Cardiology, San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas, USA.
Department of Internal Medicine, San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas, USA.
出版信息
JACC Case Rep. 2025 Jun 25;30(16):103535. doi: 10.1016/j.jaccas.2025.103535.
BACKGROUND
Papillary fibroelastomas (PFEs) are common cardiac tumors. They are usually asymptomatic and identified incidentally.
CASE SUMMARY
A 63-year-old woman presented with angina. Myocardial perfusion imaging was positive for anterior ischemia. Cardiac computed tomographic angiography (CCTA) showed no coronary atherosclerosis and a PFE within the left coronary cusp causing left main coronary artery (LMCA) occlusion during systole and early diastole. Surgical removal of the PFE resulted in symptom resolution.
DISCUSSION
Though benign, PFEs can cause coronary obstruction, usually involving the right coronary ostium. The use of CCTA is important for the localization, characterization, and visualization of PFE mobility throughout the cardiac cycle. This is a rare case of angina caused by LMCA obstruction by a mobile PFE.
背景
乳头状纤维弹性瘤（PFEs）是常见的心脏肿瘤。它们通常无症状，多为偶然发现。
病例摘要
一名63岁女性因心绞痛就诊。心肌灌注成像显示前壁缺血呈阳性。心脏计算机断层血管造影（CCTA）显示无冠状动脉粥样硬化，左冠状动脉瓣叶内有一个PFEs，在收缩期和舒张早期导致左主干冠状动脉（LMCA）闭塞。手术切除PFEs后症状缓解。
讨论
尽管PFEs是良性的，但可导致冠状动脉阻塞，通常累及右冠状动脉口。CCTA的使用对于PFEs在整个心动周期中的定位、特征描述及活动可视化很重要。这是一例由可移动的PFEs阻塞LMCA引起心绞痛的罕见病例。
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