Chest pain and palpitation caused by a left ventricular
haemangioma in an adult
Qiang Fan1* MD, Yunfei Ling1* PhD,
Qin Yang2 MD, Changping Gan1# PhD
1 Department of Cardiovascular surgery, West China Hospital, Sichuan
University
2 Department of Radiology, West China Hospital, Sichuan University
* These authors contributed equally to this work and should be
considered co-first authors
# Corresponding author information: Tel: +86 28 85422897, Fax: +86 28
85422897, E-mail: ganchangping@hotmail.com, Add: No. 37 Guo Xue Xiang,
Chengdu, Sichuan 610041, People’s Republic of China.
Keywords : hemangioma, left ventricle, symptomatic
Funding : none.
Abstract Hemangioma in heart chambers is rare, most cases with
heat hemangioma without symptom. The case we presented was an extremely
left ventricle hemangioma with hest pain and palpitation after exercise.
The tumor was resected under cardiopulmonary bypass, histopathological
analysis concluded a benign vascular tumor. Examination of the tumor
revealed vascular proliferation and mucoid degeneration in matrix.
Immunohistochemistry showed strong positive staining with antibodies
against CD31 and CD34, which supported the vascular origin of this
tumor.
A 22-year-old man was presented to the emergency room with chest pain
and palpitation after exercise for more than one month[1]. Physical
examination showed no positive signs except the heart rates was 112
beats per minute. The patient’s history was unremarkable while the body
temperature was 37.7 centigrade when he checked in. Laboratory
parameters were unremarkable, with no elevation in his levels of
high-sensitive cardiac troponin T (4.5 pg/ml, reference <14
pg/ml), N-terminal pro-brain natriuretic peptide (<5 ng/l,
reference <88 ng/l). Transesophageal echocardiography during
operation revealed a strong echo oval shaped circumscribed mass measured
17\(\times\)15mm in his left ventricle cavity with great mobility
(panels A and B, Supplementary material online, video1 and 2). His
cardiac valves and the size and function of left ventricle were normal.
Cardiovascular magnetic resonance (CMR) imaging, which revealed a
17×15mm left ventricular mass that significantly enhanced after
injection of gadolinium enhancement (panels C and D, Supplementary
material online, video3 and 4). The patient received surgical
intervention under the cardiopulmonary bypass, the tumor was identified
originating from left ventricle cavity with a pedicle connected to the
middle section of interventricular septal. The surface of the tumor was
covered by milky white colloidal substances, and red jelly-like stuff in
it (panel E and F). Histopathological analysis concluded a benign
vascular tumor. Examination of the tumor revealed vascular proliferation
and mucoid degeneration in matrix (panel G). Cells showed strong
positive staining with antibodies against CD31 (panel H) and CD34 (panel
I)[2], which supported the vascular origin of this tumor. The
patient recovered uneventfully and discharged 4 days after surgery.
Consent The study were approved by the relevant ethics
committees, and oral informed consent was obtained for the participant.