atrial myxoma

心房粘液瘤
  • 文章类型: Case Reports
    心房粘液瘤是良性原发性心脏肿瘤。它们可以表现出非特异性症状,范围从全身症状和栓塞现象,如短暂性脑缺血发作(TIA)或中风到心源性猝死。由于心房粘液瘤的非特异性表现,早期诊断可能是一个挑战。对于没有已知心血管危险因素的TIA患者,需要高度怀疑。虽然是良性的,如果不及时治疗,它可能导致严重的并发症,从栓塞现象和阻塞症状到心脏猝死。超声心动图对诊断心房粘液瘤至关重要,手术切除是最终的治疗选择。这里,我们讨论了一例TIA作为心房粘液瘤的初始表现。
    Atrial myxomas are benign primary cardiac tumors. They can present with nonspecific symptoms, ranging from constitutional symptoms and embolic phenomena such as transient ischemic attacks (TIAs) or strokes to sudden cardiac death. Early diagnosis may be a challenge due to the nonspecific presentation of atrial myxoma. A high degree of suspicion is needed in patients with TIA having no known cardiovascular risk factors. Although benign, if left untreated, it can lead to serious complications ranging from embolic phenomena and obstructive symptoms to sudden cardiac death. An echocardiogram is of fundamental importance in diagnosing atrial myxoma, and surgical resection is the ultimate treatment of choice. Here, we discuss a case of TIA as the initial presentation of atrial myxoma.
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  • 文章类型: Case Reports
    心脏粘液瘤是罕见的肿瘤,有心脏流出道阻塞和栓塞事件的风险。手术切除肿瘤最早是确定的治疗方法。我们报告了一名65岁女性患者的成功麻醉管理,该患者患有偶然的左心房粘液瘤,用于右股骨近端钉。患者无症状,无明显心脏病史。由于骨折复位不能长时间推迟,该病例在全麻下接受有创血压监测。
    Cardiac myxomas are rare tumors with risks of cardiac outflow obstruction and embolic events. Surgical excision of the tumor at the earliest is the definitive treatment. We report the successful anesthetic management of a 65-year-old female patient with incidental left atrial myxoma for right proximal femur nailing. The patient was asymptomatic with no significant cardiac history. Since fracture reduction cannot be deferred for a prolonged period, the case was taken up under general anesthesia with invasive blood pressure monitoring.
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  • 文章类型: Case Reports
    心房粘液瘤,虽然是最常见的原发性心脏肿瘤,通常表现为非特异性症状,可以模糊其诊断。该病例报告详细介绍了最初被认为患有慢性阻塞性肺疾病(COPD)的患者的运动时呼吸困难(DOE)的异常表现。DOE的常见肺部病因。诊断过程强调了DOE患者考虑心房粘液瘤的重要性,特别是当症状不能完全由明显的肺部疾病解释时。我们的发现强调了全面诊断方法的必要性,包括早期使用静息经胸超声心动图,揭示不太常见的原因,如心房粘液瘤。这个案例加强了在DOE的复杂表现中考虑替代诊断的关键作用,从而指导更准确和量身定制的患者管理。
    Atrial myxoma, though the most common primary cardiac tumor, often presents with nonspecific symptoms that can obscure its diagnosis. This case report details an unusual presentation of dyspnea on exertion (DOE) in a patient initially considered to have chronic obstructive pulmonary disease (COPD), a common pulmonary etiology of DOE. The diagnostic journey underscores the critical importance of considering atrial myxoma in patients with DOE, especially when symptoms are not fully explained by apparent pulmonary conditions. Our findings highlight the necessity of a comprehensive diagnostic approach, including the early use of resting transthoracic echocardiogram, to unveil less common causes like atrial myxoma. This case reinforces the pivotal role of considering alternative diagnoses in complex presentations of DOE, thereby guiding more accurate and tailored patient management.
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  • 文章类型: Case Reports
    Takotsubo syndrome (TTS) is a rare cardiomyopathy, but its prevalence is increasing due to the greater availability of diagnostic tools, whose pathophysiology is unknown; however, the evidence points to an excess of catecholamines that ends up generating cardiac stunning. The cause of excessive sympathetic discharge is multifactorial, and some tumors may be related to their origin. In this case report, we present a female patient with TTS whose only identified triggering factor was an atrial myxoma, which generated an unusual clinical presentation. Current multimodal diagnostic tools together with the multidisciplinary evaluation of the HeartTeam allowed an accurate diagnosis and an adequate management of the clinical picture.
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  • 文章类型: Case Reports
    心房粘液瘤的症状通常被视为心脏的三联征,栓塞,和体质症状。皮肤病表现被视为体质症状,并没有受到太多关注。
    案例介绍和文献综述。
    我收治了一名28岁的女性患者,她被转移到综合卒中中心,患有缺血性卒中,接受了静脉溶栓治疗。她的手/手指和脚/脚趾/脚底有两年的皮肤损伤史。皮肤活检显示血管周围中性粒细胞炎性皮炎,无皮肤血管炎。入院体检值得注意的是,她的手和脚的慢性皮肤变化以及右颈外动脉分布中面部右侧的急性红斑斑疹。MRI显示脑缺血累及右侧颈内动脉区域。经胸超声心动图确定了2.4厘米的心房粘液瘤,二尖瓣功能正常。她接受了简单的心脏手术,并确认了绒毛粘液瘤。在她为期8周的随访中,她已经解决了她的神经缺陷,她的皮疹已经清除了.文献综述在诊断为心房粘液瘤之前确定了另外17例前哨皮疹。皮肤变化通常在手和脚报告,可能涉及手指,棕榈,和鞋底。在8个案例中,皮肤活检发现真皮血管中的粘液瘤栓子。这些皮肤表现与1890年代首次描述的奥斯勒淋巴结和简威病变有相似之处,现在被理解为代表真皮的微栓子。这17例中有7例(41%)在最初出现皮肤变化后出现中风。我们的患者发生了主要影响右侧颈总动脉区域的栓塞事件,由于颈外动脉区域的栓塞和右侧颈内动脉区域的脑缺血而导致面部皮肤变化。
    我建议将心房粘液瘤的皮肤征象重新分类为栓塞(至真皮微脉管系统),而不是体质症状。由于皮肤活检通常无法显示粘液瘤栓子,对于游走性皮疹优先影响远端四肢的患者,医师应高度怀疑近端栓塞来源.当前哨皮疹首次出现时,心房粘液瘤的早期诊断为患者中风或周围栓塞之前的心脏手术提供了宝贵的机会窗口。
    UNASSIGNED: Presenting symptoms of atrial myxoma are classically viewed as a triad of cardiac, embolic, and constitutional symptoms. Dermatologic manifestations are viewed as constitutional symptoms and have not received much attention.
    UNASSIGNED: Illustrative case presentation and literature review.
    UNASSIGNED: I admitted a 28 y woman transferred to the comprehensive stroke center with an ischemic stroke treated with intravenous thrombolysis. She had a two year history of skin lesions in the hands/fingers and feet/toes/sole. Skin biopsies showed perivascular neutrophilic inflammatory dermatitis without skin vasculitis. Admission physical exam was notable for chronic skin changes on her hand and foot and an acute erythematous petechial rash over the right side of her face in the distribution of the right external carotid artery. MRI brain showed ischemia involving the right internal carotid artery territory. Transthoracic echocardiogram identified a 2.4 cm atrial myxoma with normal mitral valve function. She underwent uncomplicated cardiac surgery with confirmation of a villous myxoma. At her 8 week follow up visit, she had resolution of her neurologic deficits, and her skin rashes had cleared.Literature review identified 17 additional published cases of sentinel rashes preceding diagnosis of atrial myxoma. Skin changes were often reported in the hand and feet and may involve the digits, palm, and sole. In 8 cases, skin biopsy identified myxomatous emboli in dermal vessels. These cutaneous manifestations share similarities with Osler nodes and Janeway lesions first described in the 1890\'s, now understood to represent microemboli to the dermis. Seven of these 17 cases (41 %) developed strokes after the initial presentation of cutaneous changes. Our patient had an embolic event primarily affecting the right common carotid artery territory with facial cutaneous changes due to emboli to the external carotid artery territory and cerebral ischemia in the right internal carotid artery territory.
    UNASSIGNED: I recommend reclassification of the cutaneous signs of atrial myxoma as embolic (to the dermis microvasculature) rather than a constitutional symptom. As the skin biopsy often fails to show myxomatous emboli, physicians should have a high suspicion for a proximal embolic source for patients with a migratory rash preferentially affecting distal extremities. Earlier diagnosis of atrial myxoma when the sentinel rash first appears provides a valuable window of opportunity for cardiac surgery before the patient experiences stroke or peripheral emboli.
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  • 文章类型: Case Reports
    左心房肿块通常由心房粘液瘤和转移性肿瘤引起。原发性心脏肉瘤是罕见的。患者出现与肿瘤位置相关的症状。这种罕见疾病只有少数病例报道。我们报告了一名17岁的男性患者,持续2个月的呼吸急促。超声心动图显示左心房肿块,后来经手术切除,组织病理学证实为原发性心脏肉瘤。我们讨论了在这种罕见疾病的管理中遇到的诊断和治疗挑战。据我们所知,这是东非报告的第一例病例。
    Left atrial masses are commonly caused by atrial myxomas and metastatic tumors. Primary cardiac sarcomas are rare. Patients present with symptoms related to the tumor location. There are only a few case reports on this rare disease. We report the case of a 17 years old male patient presented with shortness of breath for 2-month duration. Echocardiography revealed a left atrial mass that was later surgically excised and histopathology confirmed a primary cardiac sarcoma. We discuss the diagnostic and therapeutic challenges encountered in the management of this rare disease. To the best of our knowledge, this is the first case reported in East Africa.
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  • 文章类型: Journal Article
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  • 文章类型: Case Reports
    这是2019年急性冠状病毒病肺炎的一例,发现偶然的大心房粘液瘤具有阻塞性生理,最终需要进行明确的心房切开术和切除潜在的粘液瘤的紧急治疗。
    This is a case of acute coronavirus disease 2019 pneumonia that revealed an incidental large atrial myxoma with obstructive physiology that ultimately required emergent treatment with a definitive atriotomy and resection of the underlying myxoma.
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  • 文章类型: Case Reports
    心脏肿瘤在普通人群中并不常见,在儿科人群中更是如此。在这里,我们介绍了一例无症状的7岁男性,有高危神经母细胞瘤病史,他在治疗后进行了1年的监测扫描,偶然发现心内病变是心房粘液瘤。
    Cardiac tumours are uncommon in the general population and even more so in the paediatric population. Here we present a case of an asymptomatic 7-year-old male with history of high-risk neuroblastoma who underwent 1-year post-treatment surveillance scan with an incidental finding of intracardiac lesion found to be an atrial myxoma.
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  • 文章类型: Journal Article
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