Cardiac myxoma

Cardiac myxoma is the most common primary cardiac tumor, mostly benign, malignant rare. Myxomas can occur in the heart of all the endocardial surface, 95% occurred in atrium, about 75% located in the left atrium, 20% located in the right atrium, left ventricle and right ventricle to 2.5% each. Left atrial myxoma tumor occurs in the vicinity of Waterloo Park eggs, due to clinical tumor mitral valve plug, lead to mitral stenosis or regurgitation, mucinous tumors can occur at any age, but the most common in middle age, female styles. [Pathological tumor sizes -- more pedunculated with atrial or ventricular wall connected to a variety shape, appearance sheen, translucent noticeable. Cut surface substantive, Patchy between bleeding and clotting block filled with small cysts. Under a microscope showed that the tumor cells were from Stelletta tenui Lindgren, spindle, a round or irregular in shape scattered or cords were closed to the mass distribution of myxoid stroma, the nucleus of most of monocytes may also show multinucleated giant cell tumor. Myxosarcoma different tumor cells, the nucleus, dark, we can see nuclear fission, Tumor infiltrating cells to the small vessels within the tumor thrombus formation. [Clinical manifestations of the disease -- the clinical performance depends on tumor location, size, nature and the availability and pedicle length. 25/42 pedicle elderly prone to cause atrioventricular valve stenosis or regurgitation occurred hemodynamic changes, there was a series of symptoms, small tumor pedicle short, the long-term asymptomatic. 1, symptoms (1) common early symptoms of obstructive heart palpitations, shortness of breath, reduced exercise capacity, Left atrial myxoma as obstructive pulmonary vein or mitral valve may have mitral valve disease resembles the symptoms of pulmonary bleeding; paroxysmal nocturnal dyspnea, hemoptysis silk sputum, weight can be computed jugular, hepatomegaly and lower extremity edema. Right atrial myxomas as inferior vena cava obstruction, tricuspid mouth with pericardial effusion appeared similar symptoms; Jugular venous engorgement, hepatomegaly and edema. The disease with obstructive symptoms of postural changes in the characteristics of the attack and if there are positions related to the paroxysmal vertigo and breathing difficulties. atrioventricular block tumor suddenly aroused valve stroke volume significantly decreased, fainting or sudden cardiac arrest. (2) myxoma debris embolization, or tumor thrombus peeled off the surface can occur, pulmonary embolism cycle. Left atrial myxoma embolism occurred about 40%, right atrial myxoma were rare embolism. (C) systemic symptoms of fever, ESR increase, anemia, weight loss and serum Europium 2, beta globulin abnormal increase, this may be related to tumor necrosis and hemorrhage of inflammatory cell infiltration. 2, signs (1) change the heart of a left atrial myxoma may occur : ?٠apex of the first heart sound hyperthyroidism. ?ڠpulmonary valve and the second heart sound hyperthyroidism split. ?۠sternum lower left edge can be heard early diastolic heart sounds a plop, conduction and cardiac apex and the bottom the tumor was pushed to the left room suddenly stopped. Ventricular wall or pedicel of vibration generated. In addition, the heart can be heard before the 4th District heart sounds. (2) heart murmur tumor obstruction mitral, tricuspid mouth formed mitral and tricuspid stenosis. When the tumor into ventricular cavity, there will be the atrioventricular valve regurgitation. Insufficiency may interfere with tumor valve is the result of the closure, as a result of tumor repeated contact with the valve. on the valve scarring so similar chronic rheumatic Yan or even lead to tendon rupture, the result of left atrial myxoma. apical diastolic be heard rumbling noise-like, when left lying enhanced when weakened right berth, sometimes be heard with postural changes systolic murmur (mitral regurgitation). Right atrial myxomas, the sternum left intercostal 3-4 margin contraction hear-kind of friction between diastolic murmur. Left ventricular heart myxomas can press and the bottom three projectile systolic murmur to the neck conduction, and right ventricular myxoma in the left sternal edge intercostal a 2-3 2-3-systolic murmur. ??Laboratories and other inspection -- a laboratory anemia, block ESR, serum protein electrophoresis and beta 2 Europium globulin increased. 2, ECG can atrium and ventricle increased, I-second degree atrioventricular block, incomplete right bundle branch block ECG changes. Atrial fibrillation may also have occurred. More severe disease may have ST-T changes. 3, X-ray left atrial myxoma are pulmonary bleeding, and pulmonary highlight of the left atrial and ventricular expansion Right atrial myxomas displaying the superior vena cava shadow widened, the right atrium, right ventricle to expand. 4, echocardiographic left atrial myxoma in the left ventricular cavity to see abnormal light reflex points Flake mission activities in the left atrium, Left ventricular between systolic back to the left cavity, the diastolic mitral to enter the left ventricle, mitral anterior leaflet EF reduce the slope, Left atrial enlargement. Right atrial myxomas abnormal light reflex Mission in the right heart chambers, the right atrial systolic, diastolic with tricuspid right direction Room Mobile mouth or through the tricuspid valve into the right ventricular cavity. Right atrium and right ventricle increases. 5, angiocardiography selective pulmonary angiography or continuous film radiography may appear left the room occupancy filling defect shadow indirectly confirmed atrium tumor, right atrial myxoma general for the inferior vena cava or right atrium contrast, may appear right room occupancy filling defect shadow. [Diagnosis -- diagnosis : ?٠clinical features; Obstructive symptoms, heart sounds and noises changes. ?ڠechocardiographic diagnosis is the heart myxomas the best method, In particular two-dimensional echocardiography should clearly outline tumor and activities. ?۠angiocardiography revealed Intracardiac lesions, but there are some false positives, we will have echocardiography, angiocardiography rarely used. -- [Differential diagnosis of left atrial myxoma attention and should be differentiated from mitral stenosis. Mitral stenosis often than ring for the opening flap sound, few fourth heart sounds, the noise does not change with the position, no plop. suspicious person who can conduct inspections echocardiography can be identified. Thrombosis of the left atrium spherical also easy with left atrial myxoma confused, In echocardiography showed left atrial thrombus in the left, most of the wall, The abnormal light reflex groups lack the cardiac cycle in the rapid movement of the left atrial thrombus often accompanied in mitral stenosis. thus, we can see the abnormal mitral activities reflection graphics. Right atrial myxomas should pay attention to and constrictive pericarditis, tricuspid stenosis and pulmonary stenosis differentiate breastbone left edge of its first four 3-intercostal systolic and diastolic friction between noise like symptoms, noises and positional changes such as the relevant differential diagnosis. [Treatment] of the disease have occurred in danger of sudden death, the right to be suspicious early diagnosed patients, the diagnosis is clear, an early heart surgery can get better results.