PDF(Pubmed)
Abstract：
Chest pain is a very common symptom in an emergency context. Its differential diagnosis is extensive and includes some conditions that require immediate recognition and intervention. It can also be a symptom associated with rarer diagnostic possibilities. Here, we report the case of a 53-year-old woman admitted to the emergency department due to chest pain and initially diagnosed with non-ST elevation acute myocardial infarction. A transthoracic echocardiogram revealed a large hyperechogenic round mass, suggestive of a left atrial cardiac myxoma. Coronary angiography showed no significant lesions. The patient underwent cardiac surgery with excision of the mass, whose histological diagnosis was atrial myxoma. The immediate postoperative period was uneventful, and the patient was discharged asymptomatic and without echocardiographic changes. Cardiac tumors are a rare finding, of which myxomas are the most common. Symptoms can typically result from embolism, obstruction, or constitutional symptoms. A myxoma presenting as acute chest pain and mimicking an acute coronary syndrome is an uncommon finding. This case reminds us of an extremely rare differential diagnosis of chest pain and awakens us to the usefulness and importance of using echocardiography as a diagnostic tool.
摘要：
胸痛是紧急情况下非常常见的症状。它的鉴别诊断是广泛的，包括一些需要立即识别和干预的条件。它也可以是与更罕见的诊断可能性相关的症状。这里,我们报道一例53岁女性患者,因胸痛入院急诊,最初诊断为非ST段抬高急性心肌梗死.经胸超声心动图显示一个巨大的高回声圆形肿块，提示左心房心脏粘液瘤。冠状动脉造影显示无明显病变。患者接受了心脏手术切除肿块，组织学诊断为心房粘液瘤。术后即刻平静，患者无症状出院，无超声心动图改变。心脏肿瘤是一个罕见的发现，其中粘液瘤是最常见的。症状通常由栓塞引起，阻塞,或体质症状。表现为急性胸痛并模仿急性冠状动脉综合征的粘液瘤是一个罕见的发现。这种情况使我们想起了极为罕见的胸痛鉴别诊断，并唤醒了我们使用超声心动图作为诊断工具的有用性和重要性。
