■心脏淋巴瘤是一种罕见的疾病。渗出性缩窄性心包炎可能是该疾病患者心包受累的特征。相反,心电图改变类似于Brugada综合征的表型称为Brugada表型,这些变化在治疗后改善。
■一名71岁的男子因胸痛被送往我们医院,低血压,肾功能衰竭维持性透析期间V1和V2导线的ST段抬高。到达医院后,他的ST段抬高消失了,急诊冠状动脉造影扫描显示无明显冠状动脉狭窄或阻塞。他的计算机断层扫描和超声心动图扫描显示心包积液和心包内肿块。Further,透析7天后血压下降,ST段抬高复发.因此,进行了心包穿刺术,但是血流动力学改善不足,右导管检查结果提示渗出性缩窄性心包炎。同时,心包液的流式细胞术提示B细胞淋巴瘤的诊断;然而,由于心源性休克,根治性放化疗是不可能的。患者在第17天死亡。Further,尸检显示弥漫性大B细胞淋巴瘤伴心包和心肌浸润。
■心脏淋巴瘤是罕见的,但可能与渗出性缩窄性心包炎有关,即使心包引流也可能难以管理。在这种情况下,根治性治疗,包括化疗,应该及时考虑,如果可能的话。我们的患者表现为Brugada型心电图,但没有晕厥或家族史,提示Brugada表型和不是真正的Brugada综合征由于心脏淋巴瘤。值得注意的是,尽管没有治疗,但观察到ST段抬高的暂时性改善.
UNASSIGNED: Cardiac lymphoma is a rare disease. Effusive-constrictive pericarditis can be a characteristic of pericardial involvement in patients with this disease. Conversely, a phenotype with electrocardiogram changes similar to those of Brugada syndrome is called Brugada phenocopy, and these changes improve after treatment.
UNASSIGNED: A 71-year-old man was transported to our hospital with chest pain, hypotension, and ST-segment elevation in V1 and V2 leads during maintenance dialysis for renal failure. After arrival at the hospital, his ST-segment elevation disappeared, and emergency coronary angiography scan revealed no significant coronary artery stenoses or obstructions. His computed tomography and echocardiography scans revealed pericardial effusion and an intrapericardial mass. Further, his blood pressure dropped and ST-segment elevation recurred during dialysis after 7 days. Thus, pericardiocentesis was performed, but haemodynamic improvement was insufficient, and right catheterization findings suggested effusive-constrictive pericarditis. Meanwhile, flow cytometry of the pericardial fluid suggested the diagnosis of B-cell lymphoma; however, radical chemoradiotherapy was impossible because of cardiogenic shock. The patient died on Day 17. Further, autopsy revealed diffuse large B-cell lymphoma with pericardial and myocardial infiltration.
UNASSIGNED: Cardiac lymphoma is rare but can be associated with effusive-constrictive pericarditis, which may be difficult to manage even with pericardial drainage. In such cases, radical treatment, including chemotherapy, should be promptly considered, if possible. Our patient presented with Brugada-type electrocardiogram but no syncope or family history, suggesting Brugada phenocopy and not true Brugada syndrome due to cardiac lymphoma. Notably, temporary improvement in ST-segment elevation was observed despite the absence of treatment.