arrhythmia for more than 3 years, and recently there have been morning palpitations, chest tightness, shortness of breath, numbness of the left upper limb and dizziness... The root cause of many discomforts in the 34-year-old man Zhao Dong (pseudonym) is actually a Tibetan A huge tumor in his heart! A few days ago, this rare right atrium huge mass was successfully removed with the joint efforts of doctors from Cardiovascular Surgery Department of Tianjin Medical University General Hospital of and related departments, and the heart disease that had plagued Zhao Dong for many years also disappeared.
When Zhao Donglaijin, a man from Shandong, found me, his arrhythmia had been with him for more than 3 years. Ten days before the treatment, he also developed morning palpitations, chest tightness, shortness of breath, numbness of the left upper extremity and other discomforts, and occasionally dizziness.
This year is my 30th year as a doctor, but Zhao Dong's examination results after admission to the hospital still surprised me: the electrocardiogram indicated that his heart had supraventricular tachycardia; echocardiography and esophagus color Doppler suggested that he has a huge space-occupying lesion of the atrial septum!
Generally speaking, the image shows that the space is huge, and it is in the right heart system. It is usually considered as a malignant tumor.
This is also the reason why Zhao Dong and his family moved to many hospitals and finally came to Tianjin. They are under tremendous psychological pressure and hope that experts from large hospitals can give a clear diagnosis.
Before surgery, we combined with the results of tumor marker examinations, tumor morphology and imaging manifestations, and we preliminarily judged that the tumor should not be malignant, but lipoma is more likely. This judgment made Zhao Dong and his family's psychological pressure suddenly relieved.
ultrasound tips,The patient's atrial septum can detect a moderately echogenic mass of about 4.5*3.6cm in size, and there is no clear abnormality in the structure of each valve.
Ultrasound prompts, a medium-echoic mass of about 5.0*3.6cm in the middle and upper part of the atrial septum can be seen Mass, convex to the right side of the atrium
Chest CT shows that the patient can see a mass of fat density shadow on the right side of the atrial septum, the density is relatively uniform, there is no obvious enhancement, the largest cross section is about 5.6*3.5cm
After active symptomatic treatment, Zhao Dong's body quickly adjusted to a state that can accept surgery. Because of the huge mass, it had a great impact on his heart conduction and some important heart structures. Therefore, our cardiology team had serious discussions with the hospital's ultrasound department, imaging department, anesthesiology department, operating room and other departments before the operation, and had many consultations. , Work out a detailed surgical plan and plan.
operation, after opened the patient’s atrium, it was found that the mass was as high as , superior vena cava , down to the coronary sinus ostium, and the interatrial diaphragm was cut open, like two big chestnuts growing together , Has a smooth surface. Because of the special location of the tumor and its large size-the size is about 6 cm * 5 cm * 4 cm, which is larger than a ping pong ball, so we operate very delicately. In order to avoid damaging Zhao Dong’s atrioventricular node, so as to prevent his heart from developing block and aortic valve regurgitation in the future, the entire operation took more than 3 hours, during which we kept the mass intact Stripping and excision, while using bovine pericardium tablets to repair the patient's damaged atrial septum.
(in operation)
(resectioned mass)
postoperative pathological examination showed,This tumor really is a lipoma. After the operation, Zhao Dong's symptoms such as heart palpitations and shortness of breath disappeared, and he recovered well and was discharged from the hospital soon.
After the postoperative rounds, the patient took the initiative to take a photo with me, and the mosaics couldn’t hide his joy of recovery
In life, we often hear the saying that “the heart cannot be tumor”. Indeed, has a heart tumor The incidence of is extremely low. Data shows that the incidence of primary heart tumors is as low as 0.0017%. In other words, only one or two people out of every 100,000 people are likely to develop heart tumors. Among these people, about 75% suffer from benign tumors. Among them, benign tumors called cardiac myxoma are the most common primary cardiac tumors, accounting for about half of all cardiac tumors. The incidence of cardiac lipoma suffered by Zhao Dong is second only to myxoma, accounting for 2.9%-8% of all cardiac benign tumors .
【Popular science】
Cardiac lipomas can be located in various parts of the heart and the pericardium. The patients are generally over 20 years old, and there are more men than women. Due to the slow growth of cardiac lipomas, most patients are asymptomatic. The large tumor size affects the patient's arrhythmia or causes obstruction of the inflow and outflow tracts of the heart.
The success of Zhao Dong's operation is not the result of our single department. It is not only due to the multidisciplinary collaboration in the accurate judgment of the disease and the proper treatment, but also benefits from the hospital's cardiology surgery, cardiology, anesthesiology, intensive care unit, and surgery. The close cooperation between the laboratory, imaging department and other teams is also a manifestation of the strong strength and comprehensive advantages of the General Hospital of Tianjin Medical University.
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