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An unusual right atrial myxoma triggering presumed takotsubo syndrome in a 97-year-old female
A 97-year-old female was admitted to the emergency department of our hospital due to paroxysmal nocturnal dyspnea and chest pain. At the hospital admission, the patient manifested transient psychomotor agitation and dysarthria. On physical examination, blood pressure was 115/60 mmHg and pulse 96 b.p...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Oxford University Press
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10244033/ https://www.ncbi.nlm.nih.gov/pubmed/37293189 http://dx.doi.org/10.1093/ehjcr/ytad256 |
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author | Sonaglioni, Andrea Grasso, Enzo Lombardo, Michele |
author_facet | Sonaglioni, Andrea Grasso, Enzo Lombardo, Michele |
author_sort | Sonaglioni, Andrea |
collection | PubMed |
description | A 97-year-old female was admitted to the emergency department of our hospital due to paroxysmal nocturnal dyspnea and chest pain. At the hospital admission, the patient manifested transient psychomotor agitation and dysarthria. On physical examination, blood pressure was 115/60 mmHg and pulse 96 b.p.m. On blood tests, troponine I was 0.08 ng/mL (normal range <0.04 ng/mL). Electrocardiography (ECG) showed sinus rhythm and ST segment elevation in both inferior and anterior leads except in lead V1. Transthoracic echocardiography (TTE) revealed a right atrial multilobulated, hypermobile, echogenic cauliflower mass (maximum size of 5 cm × 4 cm), which was attached to the tricuspid lateral annulus with a short stalk (Figure 1A). The right atrial mass, which had filiform extremities and was found to prolapse through the tricuspid valve into the right ventricle, was ascribed to a peduncolated myxoma. Its motion was very rapid and uncoordinated, with increased peak antegrade velocity (V(max) = 35 cm/s), as precisely measured by pulsed wave tissue Doppler imaging (PW-TDI) (Figure 1B). Estimated left ventricular ejection fraction (LVEF) was normal (60%), and no significant valvulopathy was detected. Finally, a bulging of the interatrial septum with right-to-left shunt, through a patent foramen ovale (PFO), was observed by using colour Doppler (Figure 1C). Acute ischaemic lesions were excluded by brain computed tomography scan. |
format | Online Article Text |
id | pubmed-10244033 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-102440332023-06-08 An unusual right atrial myxoma triggering presumed takotsubo syndrome in a 97-year-old female Sonaglioni, Andrea Grasso, Enzo Lombardo, Michele Eur Heart J Case Rep Images in Cardiology A 97-year-old female was admitted to the emergency department of our hospital due to paroxysmal nocturnal dyspnea and chest pain. At the hospital admission, the patient manifested transient psychomotor agitation and dysarthria. On physical examination, blood pressure was 115/60 mmHg and pulse 96 b.p.m. On blood tests, troponine I was 0.08 ng/mL (normal range <0.04 ng/mL). Electrocardiography (ECG) showed sinus rhythm and ST segment elevation in both inferior and anterior leads except in lead V1. Transthoracic echocardiography (TTE) revealed a right atrial multilobulated, hypermobile, echogenic cauliflower mass (maximum size of 5 cm × 4 cm), which was attached to the tricuspid lateral annulus with a short stalk (Figure 1A). The right atrial mass, which had filiform extremities and was found to prolapse through the tricuspid valve into the right ventricle, was ascribed to a peduncolated myxoma. Its motion was very rapid and uncoordinated, with increased peak antegrade velocity (V(max) = 35 cm/s), as precisely measured by pulsed wave tissue Doppler imaging (PW-TDI) (Figure 1B). Estimated left ventricular ejection fraction (LVEF) was normal (60%), and no significant valvulopathy was detected. Finally, a bulging of the interatrial septum with right-to-left shunt, through a patent foramen ovale (PFO), was observed by using colour Doppler (Figure 1C). Acute ischaemic lesions were excluded by brain computed tomography scan. Oxford University Press 2023-05-25 /pmc/articles/PMC10244033/ /pubmed/37293189 http://dx.doi.org/10.1093/ehjcr/ytad256 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Images in Cardiology Sonaglioni, Andrea Grasso, Enzo Lombardo, Michele An unusual right atrial myxoma triggering presumed takotsubo syndrome in a 97-year-old female |
title | An unusual right atrial myxoma triggering presumed takotsubo syndrome in a 97-year-old female |
title_full | An unusual right atrial myxoma triggering presumed takotsubo syndrome in a 97-year-old female |
title_fullStr | An unusual right atrial myxoma triggering presumed takotsubo syndrome in a 97-year-old female |
title_full_unstemmed | An unusual right atrial myxoma triggering presumed takotsubo syndrome in a 97-year-old female |
title_short | An unusual right atrial myxoma triggering presumed takotsubo syndrome in a 97-year-old female |
title_sort | unusual right atrial myxoma triggering presumed takotsubo syndrome in a 97-year-old female |
topic | Images in Cardiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10244033/ https://www.ncbi.nlm.nih.gov/pubmed/37293189 http://dx.doi.org/10.1093/ehjcr/ytad256 |
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