Atrial myxoma

Lub atrial myxoma yog lub qog nqaij hlav hauv sab qaum los yog sab xis ntawm lub plawv. Nws feem ntau loj hlob ntawm phab ntsa uas cais ob sab hauv lub siab. Cov phab ntsa no yog hu ua atrial septum.

Myxoma yog thawj lub plawv (lub plawv) mob qog. Qhov no txhais tau tias cov kabmob pib ua haujlwm hauv lub siab. Feem ntau cov qog ntshav pib nyob rau lwm qhov.

Thawj lub plawv mob qog xws li myxomas muaj tsawg. Kwv yees li 75% ntawm myxomas tshwm sim hauv sab laug atrium ntawm lub plawv. Lawv feem ntau pib hauv phab ntsa uas faib rau ob chav loj sab ntawm lub plawv. Lawv tuaj yeem tshwm sim hauv lwm qhov chaw mob plawv. Qee zaum cov pob txha atrial myxomas qee zaum txuas nrog valve rhuav tshem stenosis thiab atrial fibrillation.

Myxomas muaj ntau dua nyob hauv poj niam. Kwv yees li 1 ntawm 10 myxomas tau hla dhau los ntawm cov tsev neeg (niam txiv caj ces). Cov qog no tau hu ua myxomas thaj chaw. Lawv muaj tshwm sim ntau dua ib ntu ntawm lub plawv ib zaug, thiab feem ntau ua rau cov tsos mob tshwm sim thaum hnub nyoog yau dua.

Ntau yam myxomas yuav tsis ua rau mob tshwm sim. Cov no feem ntau pom thaum muaj kev soj ntsuam ntsuam xyuas (echocardiogram, MRI, CT) tau ua rau lwm qhov laj thawj.

Cov tsos mob yuav tshwm sim thaum twg los tau, tab sis feem ntau lawv mus nrog kev hloov pauv hauv lub cev.

Cov tsos mob ntawm tus mob myxoma kuj muaj xws li:

• Ua pa nyuaj thaum dag tiaj lossis ib sab lossis lwm yam
• Ua pa rau nyuaj thaum tsaug zog
• Lub hauv siab mob lossis nruj
• Kiv taub hau
• Tsaus muag
• Hnov ntawm kev hnov ​​koj lub plawv khiav nrawm (palpitations)
• Ua tsis taus pa nrog kev ua ub no
• Cov tsos mob vim yog embolism ntawm cov khoom siv qog
  

Cov tsos mob thiab cov tsos mob ntawm sab laug atrial myxomas feem ntau mimic mitral stenosis (txoj kev nqaim ntawm lub nruab nrab ntawm sab laug atrium thiab sab laug ventricle). Txoj cai atrial myxomas yeej tsis tshua pom cov tsos mob kom txog thaum lawv tau loj tuaj (5 ntiv dav, lossis 13 cm).

Lwm cov tsos mob tuaj yeem suav nrog:

• Bluish ntawm daim tawv nqaij, tshwj xeeb tshaj yog ntawm cov ntiv tes (Raynaud phenomenon)
• Hnoos
• Kev nkhaus ntawm cov ntsia hlau nrog nrog cov ntaub so ntswg o (pob qog) ntawm cov ntiv tes
• Ua npaws
• Cov ntiv tes uas hloov xim raws lub siab lossis nrog txias lossis ntxhov siab
• Kev tsis xis nyob (malaise)
• Mob tej pob txha
• O o nyob rau hauv qee qhov ntawm lub cev
• Lub cev yuag yam tsis ua kom yuag

Tus kws saib xyuas kev noj qab haus huv yuav ua ib qho kev kuaj mob lub cev thiab mloog koj lub plawv los ntawm lub ntsej muag tsom. Lub suab tsis hnov ​​qab los sis hnov ​​yws yws tej zaum yuav hnov. Cov suab no tuaj yeem hloov thaum koj hloov chaw lub cev.

Kev ntsuam xyuas cov duab yuav yog:

• Kev ntsuas hluav taws xob xoo
• CT scan ntawm hauv siab
• ECG
• Echocardiogram
• Kev kawm txog Doppler
• Lub plawv MRI
• Lub plawv angiography
• Lub plawv angiography

Koj tseem yuav xav tau kev kuaj ntshav nrog rau:

• Ua kom tiav cov ntshav suav (CBC) - tej zaum yuav ua rau pom ntshav tsawg thiab muaj cov qe ntshav dawb ntxiv
• Erythrocyte sedimentation tus nqi (ESR) - tej zaum yuav ntau zog

Kev phais mob txhawm rau txhawm rau tshem tawm cov qog, tshwj xeeb tshaj yog tias nws ua rau cov tsos mob plawv tsis ua haujlwm lossis kev mob ntsws.

Yog tsis kho, tus mob myxoma tuaj yeem ua rau cov ntshav txha caj qaum (mob qog lossis cov ntshav khov uas txhaws thiab mus ncig hauv cov hlab ntshav). Qhov no tuaj yeem ua rau txhaws ntshav ntshav. Cov nqaij hlav me me tuaj yeem txav mus rau lub hlwb, qhov muag lossis tes.

Yog tias cov qog loj tuaj rau hauv lub siab, nws tuaj yeem tiv thaiv kom ntshav khiav, ua rau cov tsos mob txhaws.

Teeb meem yuav suav nrog:

• Arrhythmias
• Lub ntsws ntsws ntsws qhuav
• Tej Khoom Ntawm Pob Zeb
• Thaiv lub plawv li qub

Mob pob qog - myxoma; Mob plawv qog - myxoma

• Tshuav atrial myxoma
• Muaj cai atrial myxoma

Lenihan DJ, Yusuf SW, Shah A. Cov nqaij hlav cuam tshuam rau cov hlab plawv. Hauv: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Plawv Lub Plawv: Phau Ntawv Qhia Txog Cov Tshuaj Mob plawvCov. 11th ed. Philadelphia, PA: Elsevier; 2019: cha 95.

Tazelaar HD, Maleszewski JJ. Cov qog ntawm lub plawv thiab mob pericardium. Hauv: Fletcher CDM, ed. Kev kuaj mob keeb kwm ntawm lub pobCov. Thib 5 ed. Philadelphia, PA: Elsevier; 2021: chap 2.