Cardiac hemangioma of the right atrium.

Primary cardiac tumors are rare, with an incidence range between 0.001% and 0.030% at autopsy. Recent technical advances have facilitated diagnosis and surgical treatment of such lesions. Patients with a resectable tumor usually have a good prognosis, but patients with an unresectable tumor may have a poor prognosis. This report shows a case of right atrial hemangioma growing like an extracardiac mass, with cardiac tamponade the only clinical presentation.     

A pedunculated left ventricular hemangioma initially misdiagnosed as thrombus in a woman with atypical chest pain

The incidence of cardiac masses increased as echocardiography is becoming increasingly popular. Benign tumors of the heart constitute about 72% of all primary cardiac neoplasms and hemangioma accounts for 5–10% of benign cardiac tumors. Cardiac hemangiomas are generally asymptomatic and diagnosed incidentally during echocardiography or magnetic resonance imaging (MRI). We reported a 52-year-old woman presented with atypical chest pain and exertional dyspnea. The echocardiographic examination revealed a hyperechoic round mass in the left ventricle. With an initial diagnosis of left ventricular thrombus, the patient underwent cardiac MRI. The mass was found compatible with cardiac hemangioma. It was removed surgically and histopathologic evaluation identified a cardiac hemangioma. As reports of cardiac hemangioma are extremely rare and cardiac masses are mostly thought to be thrombi or myxomas (being the most common primary cardiac tumor), such hemangioma cases warrant attention as possibility of hemangioma should also be kept in mind.     

Cardiac hemangioma complicated with cerebral and coronary embolization

Cardiac hemangiomas are rare, benign vascular tumors of the heart. Because of their clinical manifestations, diagnosis is difficult and few surgeons can draw from extensive experience. The purpose of this study was to report an additional case of cardiac hemangioma and to analyze the unexpected aspect of this disease. In our case, echocardiography demonstrated a mass in the left ventricle. Surgical resection was done using cardiopulmonary bypass. Histopathological examination revealed that the tumor was a hemangioma. The short-term outcome was favorable.     

Cardiac cavernous hemangioma.

Among primary cardiac tumors, hemangiomas are relatively rare with a reported incidence of 2.8%. To date, less than 100 cases are reported in literature. We present a 40-year-old woman with atypical chest discomfort of 1 month duration, previous history of glomus tumor of hand and a large cavernous hemangioma of right atrium.     

Cardiac phaeochromocytoma presenting with severe hypertension and chest pain

Cardiac phaeochromocytoma is a rare cause of endocrine hypertension. We report a case of a 25-year-old woman, who presented with severe hypertension and intermittent chest pain. The patient denied typical phaeochromocytoma spells of palpitation, headache, and diaphoresis. The 24-hr urinary excretion of norepinephrine was increased sevenfold above the upper limit of normal; however, the excretion of total metanephrines, epinephrine, and dopamine were normal. Computed tomography (CT) scan of the abdomen was normal. An 131I-labelled metaiodobenzylguanidine (MIBG) scan was falsely negative while the patient was taking labetalol. The cardiac phaeochromocytoma was localized with indium-111-pentetreotide scintigraphy and chest magnetic resonance imaging scan. Repeat 123I-MIBG scintigraphy was positive after discontinuing labetalol. The cardiac phaeochromocytoma was located in the right atrial groove, adjacent to the tricuspid valve, and contained multiple feeder arteries from the right coronary artery. After treatment with volume expansion, alpha-methyl-p-tyrosine, and alpha- and beta-adrenergic blockade, surgical resection was performed. While under cardiopulmonary bypass, coronary bypass grafting and tricuspid annuloplasty were performed to facilitate the complete surgical resection of the 4.5-cm tumour. The surgical course was uncomplicated, with complete cure of hypertension and normalization of catecholamine excretion. Post-operative cardiac function, as measured by echocardiogram, was normal. Although cardiac phaeochromocytoma may be highly vascular, invasive and difficult to resect, it can be cured.     

Cardiac hemangioma: a report of two cases and review of the literature

Cardiac hemangioma is extremely rare. We encountered two patients with cardiac hemangioma detected by thoracic echocardiography during a medical checkup. In the first case, transthoracic echocardiography revealed a pedunculated tumor in the left ventricle. Selective left coronary angiography demonstrated that the main feeding artery of the tumor arose from the third diagonal branch of the left anterior descending coronary artery. In the second case, thoracic and transesophageal echocardiography showed an oval tumor arising from the right atrium. Both tumors were successfully resected. Histopathological examination revealed that one of the tumors was a capillary hemangioma and the other was a mixed capillary and cavernous hemangioma. After operation, both patients had an uneventful recovery without any complications.     

Central venous catheter malposition presenting as chest pain

Erroneous positioning of central venous catheters in small tributaries of large central veins is a rare occurrence. We describe three such unusual incidents involving cannulation of the left internal mammary vein. Malposition was suspected when infusion of hypertonic parenteral nutrition led to persistent precordial pain. Unusual chest pain syndromes may indicate central venous catheter malposition and have not previously been described.     

Right atrial myxoma associated with vascular malformation and atypical chest pain

A 58-yr-old woman with a right atrial myxoma associated with a vascular malformation supplied by the right coronary artery is described. She presented with atypical chest pain that was reproduced during angiography of the malformation. Findings were confirmed during surgery. © 1992 Wiley-Liss, Inc.     

Primary cardiac paraganglioma with dual coronary blood supply presenting with angina chest pain

Primary cardiac paraganglioma (pheochromocytoma) is very rare, constituting only 1% of cardiac tumours. A case of a 44-year-old woman presenting with angina chest pain and a tumour with dual blood supply from both the right and left coronary arteries is reported.     

Cardiac tuberculoma presenting as thrombotic thrombocytopenic purpura-hemolytic uremic syndrome

Thrombotic thrombocytopenic purpura-hemolytic uremic syndrome (TTP-HUS) is a unique multisystem syndrome. It can present with either chronic or subacute infections. Tuberculosis (TB) is a chronic infection that has been reported to present with TTP-HUS as tuberculous endocarditis in the presence of immunodeficiency and implanted medical devices in regions where TB is endemic. Tuberculomas are space occupying lesions most commonly found in the brain in immunocompromised individuals. Herein, we present a rare association of tuberculosis with endocarditis manifesting as a tuberculoma and presenting as TTP-HUS in an immunocompetent patient and resident of the United States.     

以体循环淤血为主要表现的淀粉样变性心肌病临床特点分析

目的分析探讨淀粉样变性心肌病的临床特点。方法对7例淀粉样变性心肌病患者行超声心动图、X线胸片、电子计算机断层摄影术(CT)及常规血生化检查,分析归纳其临床特点、超声表现及辅助检查结果。结果7例患者,2例猝死,其中1例患者曾用免疫抑制剂及激素治疗,一度好转,后猝死。结论对55岁以上男性患者,出现体循环淤血的限制型心肌病表现时,超声心动图表现为左心室对称性或非对称性心肌肥厚伴收缩功能障碍,而心电图呈低电压,应高度怀疑淀粉样变性心肌病。     

Congenital esophageal stenosis presenting as noncardiac,esophageal chest pain

Summary A case of a 31-year-old female with congenital esophageal stenosis presenting with symptoms of chest pain caused by esophageal dysmotility is described. The involved segment in congenital esophageal stenosis has a characteristic thickening of the muscularis propria layer, as seen by EUS examination. In these patients, symptoms of dysphagia can be managed with esophageal dilation and noncardiac esophageal chest pain responds to pharmacotherapy with diltiazem.The opinions and assertions contained herein are the private ones of the authors and are not to be construed as official policy or reflecting the views of the Army or the Department of Defense.     

术中超声心动图和心脏瓣膜手术

术中超声心动图包括经食管和心外膜超声心动图,业已成为各种心脏手术中即刻疗效评价的不可或缺的重要工具,本文旨在两种超声技术在心脏瓣膜手术中的研究及其价值作一概述。