PDF(Pubmed)
Abstract：
UNASSIGNED: Patients with malignancy who experience metastasis to cardiac structures may exhibit ST-segment elevations and acute coronary syndrome (ACS) through poorly understood pathophysiologic mechanisms. We present a case in which vasodilator stress cardiovascular magnetic resonance provides unique insight into one such patient who suffered from recurrent episodes resembling ACS.
UNASSIGNED: A 58-year-old male with metastatic lung adenocarcinoma presented with refractory angina and dynamic inferior electrocardiogram changes. The patient was referred for adenosine stress cardiovascular magnetic resonance, revealing multiple territories of abnormal perfusion during rest with improvement during adenosine infusion. Subsequent computed tomography displayed tumour encasement of the right coronary artery. Taken together, vasodilator-responsive extrinsic compression of multiple epicardial coronary arteries was suspected. Outpatient oncology follow-up for chemoimmunotherapy initiation was arranged with the hope that reducing tumour burden might alleviate coronary compression. However, in the ensuing months, the patient\'s disease advanced beyond the point of which his symptoms could be controlled medically, and he was ultimately enrolled in hospice care.
UNASSIGNED: Encasement of coronary arteries can result in anginal symptoms if their position impairs coronary arterial flow. The presented case highlights the unique manner in which these lesions might behave on stress cardiac magnetic resonance imaging. Clinicians who encounter such unusual findings on vasodilator stress imaging should consider metastatic lesions to the cardiac structures on the differential diagnosis.
UNASSIGNED: A 58-year-old male with metastatic lung adenocarcinoma presented with refractory angina and dynamic inferior electrocardiogram changes. The patient was referred for adenosine stress cardiovascular magnetic resonance, revealing multiple territories of abnormal perfusion during rest with improvement during adenosine infusion. Subsequent computed tomography displayed tumour encasement of the right coronary artery. Taken together, vasodilator-responsive extrinsic compression of multiple epicardial coronary arteries was suspected. Outpatient oncology follow-up for chemoimmunotherapy initiation was arranged with the hope that reducing tumour burden might alleviate coronary compression. However, in the ensuing months, the patient\'s disease advanced beyond the point of which his symptoms could be controlled medically, and he was ultimately enrolled in hospice care.
UNASSIGNED: Encasement of coronary arteries can result in anginal symptoms if their position impairs coronary arterial flow. The presented case highlights the unique manner in which these lesions might behave on stress cardiac magnetic resonance imaging. Clinicians who encounter such unusual findings on vasodilator stress imaging should consider metastatic lesions to the cardiac structures on the differential diagnosis.
摘要：
未经证实：经历心脏结构转移的恶性肿瘤患者可能通过对病理生理机制知之甚少而出现ST段抬高和急性冠脉综合征(ACS)。我们介绍了一个案例，其中血管扩张剂应激心血管磁共振为一名患有类似ACS的复发性发作的患者提供了独特的见解。
UNASSIGNED：一名58岁男性转移性肺腺癌患者，表现为顽固性心绞痛和动态下心电图改变。患者接受了腺苷应激心血管磁共振检查，在腺苷输注期间改善，在休息期间显示多个区域的异常灌注。随后的计算机断层扫描显示右冠状动脉的肿瘤包裹。一起来看,怀疑多个心外膜冠状动脉的血管扩张反应性外源性压迫。安排了对化疗免疫疗法的门诊肿瘤随访，希望减轻肿瘤负担可以减轻冠状动脉压迫。然而,在接下来的几个月里，患者的疾病进展超过了他的症状可以在医学上得到控制的程度，他最终被纳入了临终关怀护理。
未经证实：如果冠状动脉的位置损害冠状动脉血流，冠状动脉的包绕会导致心绞痛症状。所呈现的病例强调了这些病变在应力心脏磁共振成像中可能表现的独特方式。在血管扩张剂应力成像中遇到这种异常发现的临床医生应在鉴别诊断中考虑心脏结构的转移性病变。
UNASSIGNED：一名58岁男性转移性肺腺癌患者，表现为顽固性心绞痛和动态下心电图改变。患者接受了腺苷应激心血管磁共振检查，在腺苷输注期间改善，在休息期间显示多个区域的异常灌注。随后的计算机断层扫描显示右冠状动脉的肿瘤包裹。一起来看,怀疑多个心外膜冠状动脉的血管扩张反应性外源性压迫。安排了对化疗免疫疗法的门诊肿瘤随访，希望减轻肿瘤负担可以减轻冠状动脉压迫。然而,在接下来的几个月里，患者的疾病进展超过了他的症状可以在医学上得到控制的程度，他最终被纳入了临终关怀护理。
未经证实：如果冠状动脉的位置损害冠状动脉血流，冠状动脉的包绕会导致心绞痛症状。所呈现的病例强调了这些病变在应力心脏磁共振成像中可能表现的独特方式。在血管扩张剂应力成像中遇到这种异常发现的临床医生应在鉴别诊断中考虑心脏结构的转移性病变。
