■左心房粘液瘤是二尖瓣梗阻的不典型原因。如果事态发展,突发性肺水肿可能是第一表现。
我们提供了一例50岁女性因呼吸困难入院的病例报告。患者在住院前三年克服了中风,经胸超声心动图阴性。通过回忆和体检,假设COPD恶化,患者得到了相应的治疗。由于患者显示了许多射血分数保留的心力衰竭的危险因素,进行了经胸超声心动图检查。在左心房发现了一个巨大的息肉样肿块,导致严重的二尖瓣阻塞.随后的经食道超声心动图证实了这一发现。病人接受了紧急心脏手术,肿瘤被成功切除.组织学检查显示心脏粘液瘤。心脏手术后病人感觉很好,肿瘤没有复发。
■我们提供了一例在呼吸困难患者中偶然发现的快速生长的粘液瘤的病例报告。我们强调了肿瘤的快速生长速度以及由二尖瓣阻塞引起的肺水肿的误诊迹象。
结论:粘液瘤是心脏最常见的原发性肿瘤,可以表现出各种症状,例如发烧,减肥,血栓栓塞,或者二尖瓣阻塞.COPD急性加重和心源性肺水肿的症状可以重叠,并且仅通过回忆和体格检查很难区分。经胸超声心动图对心脏肿块具有很高的敏感性,是怀疑这些肿块时的首选检查。
UNASSIGNED: Myxoma of the left atrium is a less typical cause of mitral obstruction. If this develops, a flash pulmonary oedema can be the first manifestation.
UNASSIGNED: We present a case report of a 50-year-old woman who was admitted to our internal department because of dyspnoea. The patient overcame a stroke three years before the index hospitalisation with a negative transthoracic echocardiography. By anamnesis and physical examination, an exacerbation of COPD was assumed, and the patient was treated accordingly. As the patient showed numerous risk factors for heart failure with preserved ejection fraction, transthoracic echocardiography was performed. A large polypoid mass was found in the left atrium, which caused severe mitral obstruction. Subsequent transoesophageal echocardiography confirmed this finding. The patient underwent urgent cardiac surgery, and the tumour was successfully resected. A histological examination revealed a cardiac myxoma. After the cardiac surgery the patient felt well, and no recurrence of the tumour occurred.
UNASSIGNED: We provide a case report of a fast-growing myxoma that was incidentally found in a patient with dyspnoea. We highlight the fast growth rate of the tumour and the potential for misdiagnosed signs of pulmonary oedema caused by mitral obstruction.
CONCLUSIONS: Myxomas are the most common primary tumours of the heart, which can manifest a variety of symptoms such as fever, weight loss, thromboembolism, or mitral obstruction.The symptoms of acute exacerbation of COPD and cardiogenic pulmonary oedema can overlap and can be difficult to differentiate by anamnesis and physical examination alone.Transthoracic echocardiography has a high sensitivity for cardiac masses and is the examination of choice when these are suspected.