妊娠合并左心房黏液瘤的成功治疗一例

Successful Management of a Maternal Left Atrial Myxoma in Advanced Pregnancy: A Case Report

摘要: 本报告介绍一例罕见病例，患者为孕37周 + 6天的38岁女性，主诉胸闷、心悸超过两个月，入院前一周加重。进一步的超声心动图检查发现左心房内有一个带蒂附着于房间隔的大型高回声团块(62 × 25 × 35 mm)，符合左心房黏液瘤诊断。经多学科团队讨论后，患者接受了紧急剖宫产术，分娩一法洛四联症婴儿。随后，在术后第12天，成功切除了左心房黏液瘤。本病例强调，在妊娠期，对于出现非特异性心脏症状的孕妇，鉴别诊断中必须包含心脏肿瘤，早期识别、及时进行超声心动图检查以及多学科协作对于优化此类复杂妊娠的结局至关重要。

Abstract: In this report, we present a rare case of a 38-year-old woman at 37 + 6 weeks of gestation who experienced chest tightness and palpitations for over two months, worsening in the week prior to admission. Futher echocardiography identified a large, hyperechoic mass (62 × 25 × 35 mm) in the left atrium with a pedicle attached to the interatrial septum, consistent with a left atrial myxoma. Following a multidisciplinary team discussion, the patient underwent an urgent cesarean section, delivering an infant with tetralogy of Fallot. Subsequently, on the 12th postoperative day, the left atrial myxoma was successfully excised. This case underscores that during pregnancy, cardiac tumors must be included in the differential diagnosis for pregnant women presenting with nonspecific cardiac symptoms. Early recognition, timely echocardiography, and multidisciplinary collaboration are crucial for optimizing outcomes in such complex pregnancies.