广泛的右心室参与血栓和心肌炎:在先进的肝细胞癌中意外发现
Willette Valjean P Go1, Renato C Ong1, Simonette T Sawit1
1Department of Medicine, Section of Cardiology, Makati Medical Center, Makati, Philippines.
JACC. Case reports
|September 19, 2025
概括
这种罕见的病例详细介绍了一名患有晚期肝细胞癌 (HCC) 的患者,该患者患有右心室瘤血栓和心肌炎. 管理方面的挑战凸显了心脏瘤学领域多学科护理的需要.
科学领域:
- 心脏瘤学 - 心脏瘤学
- 与恶性瘤有关的心脏并发症.
- 肝细胞癌 (HCC) 是一种肝细胞癌.
背景情况:
- 心脏参与恶性瘤是罕见的.
- 在没有右心房延伸的HCC中,右心室瘤血栓异常罕见.
- 对HCC的全身疗法可能会增加血栓形成和心脏功能障碍的风险.
研究的目的:
- 报告一个非常罕见的右心室瘤血栓在第四阶段的情况.
- 讨论在HCC中诊断挑战和心脏并发症的管理.
- 强调在复杂的心脏瘤病例中多学科方法的重要性.
主要方法:
- 一个54岁的男性患有第四期HCC的病例报告.
- 使用压力心声学和心磁共振成像 (CMR) 进行诊断.
- 与腹部成像相关的心脏发现,用于瘤复发和血栓负担.
主要成果:
- 患者由于右心室外流通道阻塞和左心室隔膜透而出现胸部不适.
- 心脏MRI显示急性至亚急性心肌炎.
- 腹部成像证实瘤复发,并在后肝下静脉中形成大血栓.
结论:
- 系统性HCC疗法可能会导致血栓形成,心脏功能障碍和心肌炎.
- 目前还没有确定的指导方针来管理RV瘤血栓与流出管道阻塞和心肌炎.
- 共享决策和多学科方法对于优化复杂心脏瘤护理结果至关重要.
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