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Myxom des rechten Vorhofs als Dreihöhlentumor des Herzens

Klinische, hämodynamische, angiographische und morphologische Befunde

Right atrial myxoma involving three Chambers of the heart

Clinical, haemodynamic, angiographic and morphologic findings

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Summary

In a 25 year old male a right atrial myxoma had extended through the right ventricle into the pulmonary artery and through a patent foramen ovale into the left atrium, leading to refractory right heart failure with acute abdominal pain.

Clinical and catheter data showed tricuspid insufficiency and -stenosis as well as pulmonary stenosis. Right ventricular angiography demonstrated a huge filling defect in the ventricle and atrium. Correspondingly, autopsy showed almost complete obstruction of the right heart by a myxomatous tumor.

The clinical and hemodynamic findings caused by obstruction and disturbance of the av-valve as well as the unusual auscultatory phenomena, ECG changes and cardiac catheter data with angiographic findings of intracavitary tumors are discussed.

Zusammenfassung

Bei einem 25jährigen Patienten hatte ein vom rechten Vorhof ausgehendes Myxom, das durch den rechten Ventrikel in den Anfangsteil der Pulmonalarterie und durch ein spaltförmig offenes Foramen ovale in den linken Vorhof vorgewachsen war, zu einer rasch zunehmenden therapieresistenten Einflußstauung mit akuten abdominellen Beschwerden geführt. Klinisch und bei der Herzkatheteruntersuchung waren eine Tricuspidalinsuffizienz und -stenose sowie eine Pulmonalstenose nachweisbar. Die Ventrikelangiographie erbrachte einen ausgedehnten Füllungsdefekt im Vorhof und Ventrikel. Entsprechend zeigte die Obduktion eine fast völlige Ausfüllung des rechten Herzens durch den weichlichen hämorrhagischen Tumor.

Die durch Füllungsbehinderung und Störung der Funktion der Atrioventrikularklappe hervorgerufenen klinischen Besonderheiten einschließlich der außergewöhnlichen auskultatorischen Befunde, die EKG-Veränderungen und die bei der Herzkatheterisierung gewonnenen hämodynamischen Daten einschließlich der angiographischen Bilder werden an Hand des eigenen Falles erörtert.

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Authors and Affiliations

  1. II. Medizinische Klinik und Poliklinik der Universität Mainz, Germany

    K. F. Lang, H. G. Just, J. Löhr, L. V. Habighorst & J. v. Mengden

  2. Institut für klinische Strahlenkunde der Universität Mainz, Germany

    K. F. Lang, H. G. Just, J. Löhr, L. V. Habighorst & J. v. Mengden

  3. Pathologisches Institut der Universität Mainz, Germany

    K. F. Lang, H. G. Just, J. Löhr, L. V. Habighorst & J. v. Mengden

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Lang, K.F., Just, H.G., Löhr, J. et al. Myxom des rechten Vorhofs als Dreihöhlentumor des Herzens. Klin Wochenschr 50, 725–731 (1972). https://doi.org/10.1007/BF01487621

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