Zalaquett Ziad, El Roumi Joseph, Collier Patrick
Division of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Division of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
JACC Case Rep. 2025 Sep 3;30(26):104825. doi: 10.1016/j.jaccas.2025.104825.
Lipomatous hypertrophy of the interatrial septum (LHIS) is a benign cardiac lesion characterized by excessive fat accumulation in the interatrial septum, often sparing the fossa ovalis. Although typically asymptomatic, severe cases may lead to hemodynamic compromise.
We report 2 cases of exuberant symptomatic LHIS requiring surgical intervention. The first patient presented with dyspnea and upper extremity swelling, whereas the second had progressive exertional dyspnea. Multimodality imaging confirmed large interatrial septal masses leading to hemodynamic compromise. Both underwent successful surgical resection with histopathologic confirmation of benign adipose tissue. These cases highlight the importance of multimodality imaging in diagnosing and assessing LHIS in ambiguous and symptomatic cases.
LHIS is an often underrecognized entity that can lead to significant hemodynamic complications. Comprehensive imaging and timely surgical intervention are key to optimal management in severe cases.
房间隔脂肪肥厚（LHIS）是一种良性心脏病变，其特征是房间隔脂肪过度堆积，通常不累及卵圆窝。虽然通常无症状，但严重病例可能导致血流动力学受损。
我们报告2例症状明显的LHIS病例，需要手术干预。第一例患者出现呼吸困难和上肢肿胀，而第二例患者有进行性运动性呼吸困难。多模态成像证实房间隔有较大肿块，导致血流动力学受损。两人均接受了成功的手术切除，病理组织学证实为良性脂肪组织。这些病例强调了多模态成像在诊断和评估不明确及有症状的LHIS病例中的重要性。
LHIS是一种常被忽视的疾病，可导致严重的血流动力学并发症。综合成像和及时的手术干预是严重病例最佳治疗的关键。
