PDF(Pubmed)
Abstract：
BACKGROUND: Myxomas are the most common primary cardiac tumor and typically originate in the left atrium. Atrial myxomas may present following complications of obstruction and emboli. If an atrial myxoma goes untreated, complications such as congestive heart failure, embolic stroke, and sudden death can occur.
METHODS: A 58-year-old Caucasian male presented following a cardiac arrest. He was taken emergently to the cardiac catheterization lab and received two drug eluting stents. Following the procedure, he was found to have a left atrial mass that was intermittently obstructing the mitral valve on echocardiography. After leaving the cardiac catheterization lab, he was hypotensive and placed on multiple intravenous medications for hemodynamic support as well as an Impella device. Following medical optimization, he underwent one vessel coronary artery bypass graft as well as surgical excision of the left atrial mass, which pathology had shown to be an atrial myxoma.
CONCLUSIONS: This patient\'s case of cardiogenic shock following revascularization was complicated by the identification of an atrial myxoma, which, when large enough, can obstruct blood flow through the mitral valve leading to acute mitral dynamic stenosis. This condition results in circulatory collapse due to obstruction of the left ventricle in diastole as the myxoma occludes the mitral valve.
METHODS: A 58-year-old Caucasian male presented following a cardiac arrest. He was taken emergently to the cardiac catheterization lab and received two drug eluting stents. Following the procedure, he was found to have a left atrial mass that was intermittently obstructing the mitral valve on echocardiography. After leaving the cardiac catheterization lab, he was hypotensive and placed on multiple intravenous medications for hemodynamic support as well as an Impella device. Following medical optimization, he underwent one vessel coronary artery bypass graft as well as surgical excision of the left atrial mass, which pathology had shown to be an atrial myxoma.
CONCLUSIONS: This patient\'s case of cardiogenic shock following revascularization was complicated by the identification of an atrial myxoma, which, when large enough, can obstruct blood flow through the mitral valve leading to acute mitral dynamic stenosis. This condition results in circulatory collapse due to obstruction of the left ventricle in diastole as the myxoma occludes the mitral valve.
摘要：
背景：粘液瘤是最常见的原发性心脏肿瘤，通常起源于左心房。阻塞和栓塞并发症后可能出现心房粘液瘤。如果心房粘液瘤得不到治疗，并发症，如充血性心力衰竭，栓塞性中风,可能会突然死亡。
方法：一名58岁男性高加索人出现心脏骤停。他被紧急送往心脏导管插入实验室，并接受了两个药物洗脱支架。按照程序，在超声心动图中发现他有一个间歇性阻塞二尖瓣的左心房肿块。离开心导管实验室后,他有低血压，并接受了多种静脉药物的血液动力学支持以及Impella装置。在医疗优化之后，他接受了一根血管冠状动脉旁路移植术以及左心房肿块的手术切除，病理显示是心房粘液瘤。
结论：该患者血运重建后的心源性休克病例因鉴定为心房粘液瘤而复杂化，which,当足够大的时候，可以阻碍通过二尖瓣的血流，导致急性二尖瓣动态狭窄。由于粘液瘤阻塞二尖瓣，这种情况会导致心脏舒张期左心室阻塞而导致循环塌陷。
方法：一名58岁男性高加索人出现心脏骤停。他被紧急送往心脏导管插入实验室，并接受了两个药物洗脱支架。按照程序，在超声心动图中发现他有一个间歇性阻塞二尖瓣的左心房肿块。离开心导管实验室后,他有低血压，并接受了多种静脉药物的血液动力学支持以及Impella装置。在医疗优化之后，他接受了一根血管冠状动脉旁路移植术以及左心房肿块的手术切除，病理显示是心房粘液瘤。
结论：该患者血运重建后的心源性休克病例因鉴定为心房粘液瘤而复杂化，which,当足够大的时候，可以阻碍通过二尖瓣的血流，导致急性二尖瓣动态狭窄。由于粘液瘤阻塞二尖瓣，这种情况会导致心脏舒张期左心室阻塞而导致循环塌陷。
