Iannoni E, Mocchegiani R, Peruzzini M, Gigli L, Bassotti S, Vittori N
INRCA sede di Ancona, Ospedale Geriatrico Servizio di Cardiologia.
Minerva Cardioangiol. 1995 Jul-Aug;43(7-8):329-34.
We describe the case of a 73-year-old man with cardiac failure due to hypertensive heart disease, chronic atrial fibrillation, prior ischemic stroke and acute ischemia of the left leg probably embolic in nature, in whom transthoracic echocardiography (TTE) detected a large left atrial mass compatible with thrombus. Transesophageal echocardiography (TEE) was performed to better evaluate the atrial mass. TTE showed a mass that was firmly attached to the wall of the left atrium, compact, homogeneous and stationary, indicating a relatively low embolic risk. On the other hand TEE clearly detected a marked motility and echographic unhomogeneity of the atrial mass, suggesting a poorer prognosis and urgent surgical referral due to high impending embolik risk. This case further supports the superiority of TEE to TTE in the assessment of intracardiac masses and, in particular, of embolik risk in a patient with left atrial thrombosis.
我们描述了一名73岁男性患者的病例，该患者因高血压性心脏病、慢性心房颤动、既往缺血性中风以及左腿急性缺血（可能为栓塞性质）而出现心力衰竭，经胸超声心动图（TTE）检测到左心房有一个与血栓相符的大肿块。进行了经食管超声心动图（TEE）以更好地评估心房肿块。TTE显示肿块牢固附着于左心房壁，质地紧密、均匀且固定，表明栓塞风险相对较低。另一方面，TEE清楚地检测到心房肿块有明显的活动和超声不均匀性，提示预后较差且因即将发生的高栓塞风险需紧急转诊手术。该病例进一步支持了TEE在评估心内肿块，特别是在评估左心房血栓患者的栓塞风险方面优于TTE。
