巨大的左心房感染性心內膜炎但未感染瓣膜的心臟超音波表現

Left Atrial Infective Endocarditis with Giant Vegetation without Involvement of the Mitral Valve —— A Case Report of Transesophageal Echocardiography in Diagnosis

感染性心內膜炎最常發生於瓣膜，感染性心內膜炎沒有侵犯到瓣膜是非常罕見的。心臟超音波對感染性心內膜炎贅生物的診斷是很有用的檢查，我們提出一個左心房感染性心內膜炎需接受開心手術的病例，經食道心藏超音波顯示其贅生物位於左心房後璧而完全無影響僧帽瓣，且且其贅生物在心舒張期會掉入左心室。文中亦討論感染性心內膜炎及感染性黏液瘤鑑別診斷和麻醉方面考量。

Cardiac valves are the most commonly victimized sites of infective endocarditis. The vegetations migrating outside the valves are quite rare. Echocardiography is a sensitive method for detecting these lesions. We report a case of unusual echocardiographic presentation of infective endocarditis. Transesophageal echocardiography showed a giant tonguelike echogenic mass, which attached to the posterior wall of left atrium without involving the mitral valve. Also, we discuss the differential diagnosis of infective endocarditis and myxoma, as well as the considerations of anesthetic management of intracardiac mass.