■除了血栓,在评估严重风湿性二尖瓣狭窄和心房纤颤患者的心肺症状恶化时,也要考虑罕见的肿瘤如乳头状纤维弹性瘤的可能性。
■心脏乳头状纤维弹性瘤是一种罕见的良性心内膜肿瘤,通常见于主动脉瓣。风湿性心脏病影响二尖瓣和主动脉瓣上的乳头状纤维弹性瘤的同时发生很少,有限的记录实例。这个独特的病例可以增强我们对临床表现的理解,诊断方法,管理选项,以及在这两种情况下对患者预后的影响。我们介绍了一名47岁的妇女因呼吸困难和疲劳恶化而入院的情况,在此期间,她发现了主动脉瓣乳头状纤维弹性瘤。进一步的调查显示她的左心房和左心耳有两个血栓,伴随着严重的风湿性二尖瓣狭窄。病人接受了血栓切除术,二尖瓣置换术,保留瓣膜的主动脉瓣肿瘤切除术。手术后,病人的恢复并不显著。该病例报告强调需要对风湿性二尖瓣狭窄患者进行全面评估,考虑到所有可能的病因。虽然血栓在二尖瓣狭窄和心房颤动中是典型的,应该认识到罕见的肿瘤,如乳头状纤维弹性瘤,强调怀疑时进一步评估的重要性。重要的是,无症状的心脏乳头状纤维弹性纤维瘤患者应接受手术治疗,以降低肿瘤栓塞的潜在风险.
UNASSIGNED: Besides thromboses, it\'s crucial to also consider the rare possibility of tumors like papillary fibroelastomas when evaluating worsening cardiopulmonary symptoms in patients with severe rheumatic mitral stenosis and atrial fibrillation.
UNASSIGNED: Cardiac papillary fibroelastoma is a rare and benign endocardial tumor typically found on the aortic valve. The simultaneous occurrence of rheumatic heart disease affecting the mitral valve and papillary fibroelastoma on the aortic valve is infrequent, with limited documented instances. This unique
case can enhance our understanding of the clinical presentation, diagnostic approaches, management options, and implications for patient outcomes in these two conditions. We present the
case of a 47-year-old woman who was admitted to the hospital due to worsening dyspnea and fatigue, during which time she discovered an aortic valve papillary fibroelastoma. Further investigations revealed two thrombi in her left atrium and left atrial appendage, along with significant rheumatic mitral valve stenosis. The patient underwent thrombectomy, mitral valve replacement, and valve-sparing aortic valve tumor resection. Following surgery, the patient\'s recovery was unremarkable. This
case report emphasizes the need for a comprehensive evaluation in patients with rheumatic mitral stenosis, considering all possible etiologies. While thrombi are typical in mitral stenosis and atrial fibrillation, the rare presence of tumors like papillary fibroelastomas should be recognized, underscoring the importance of further assessment when suspicion arises. Importantly, individuals with asymptomatic cardiac papillary fibroelastomas should undergo surgical treatment to minimize the potential risk of tumoral embolization.