Left Atrial Myxoma Causing Coronary Steal: An Atypical Cause of Angina
Left Atrial Myxoma Causing Coronary Steal: An Atypical Cause of Angina
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DOI：
10.14503/thij-14-4220
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发表时间：
2015-06-01
影响因子：
0.9
通讯作者：
Bush, Charles A.
中科院分区：
文献类型：
--
作者：
Stiver, Kevin;Bittenbender, Peter;Bush, Charles A.
摘要心脏黏液瘤是一种罕见的原发性心脏肿瘤，通常以呼吸困难或全身栓塞表现。冠状动脉盗血是一种罕见的血流不平衡现象，主要见于接受冠状动脉旁路移植术和锁骨下动脉狭窄的患者，我们报告一例72岁女性患者，表现为疲劳、虚弱和劳力性胸闷，心脏负荷试验结果异常。冠状动脉造影的结果显示没有阻塞性冠状动脉疾病，但发现一个大的心内左心房质量，由2个异常冠状动脉供应。该患者成功结扎了异常冠状动脉并切除了肿块，组织学上为心房粘液瘤。患者的症状消失，重复心脏负荷试验的结果是normal.To我们所知，这是第一个报告的高度血管化的心房粘液瘤，导致冠状动脉盗血的客观证据缺血，并随后决议后切除的质量和结扎的异常冠状动脉。
Cardiac myxomas are rare primary cardiac tumors that usually present with dyspnea or manifestations of systemic embolization. Coronary steal is a rare phenomenon of unbalanced blood flow that is seen primarily in patients who have undergone coronary artery bypass grafting and have subclavian artery stenosis.We report the case of a 72-year-old woman who presented with fatigue, weakness, and exertional chest heaviness and had abnormal results on a cardiac stress test. The results of coronary angiography showed no obstructive coronary artery disease but revealed a large intracardiac left atrial mass that was supplied by 2 anomalous coronary arteries. The patient underwent successful ligation of the anomalous coronary arteries and resection of the mass, which was histologically an atrial myxoma. The patient's symptoms resolved, and results of a repeat cardiac stress test were normal.To our knowledge, this is the first report of a highly vascularized atrial myxoma that caused coronary steal with objective evidence of ischemia, and with subsequent resolution after resection of the mass and ligation of the anomalous coronary arteries.