Guz lewej komory serca u nastolatka

Abstract

Asymptomatic 17-years-old boy with a suspicion of the heart tumor was admitted to the Cardiology Department for further investigation. Due to the murmur over the heart echocardiography was performed revealing a bright mass near the left ventricular apex. He was in a good physical condition, no symptoms like chest pain, shortness of breath, syncope, palpitations were reported. On physical examination diminished heart sounds and systolic murmur 2-3/6 in the Levin’s scale over the heart were found. Laboratory data including troponin T, CK, CK-MB, NSE, urea acid, marker were within normal limits. On ECG abnormalities of the repolarization were recorded (ST segment depression and T waves inversion in the II, III, aVF leads). Transthoracic echocardiogram revealed a 4.7 x 5.8 cm tumor within the postero-lateral wall of the left ventricle, without left ventricular inflow nor outflow obstruction. Based on cardiac magnetic resonance hemangioma supplied from the right coronary artery was suspected. Cardiac catheterization was performed, the left ventricular mass with supply from vascular network of the right coronary artery was confirmed. No abnormalities of the central nervous system in magnetic resonance were found. Full-body positron emission tomography showed cardiac mass without any evidence of extra-cardiac fluorodeoxyglucose-avid disease. Cardiac hemangioma was recognized. Pharmacological treatment with propranolol was introduced without any impact on the tumor size during 6 months follow-up.