RESUMO

Cardiac lipomas are rare tumors. They usually remain asymptomatic for a long time and cause angina, arrhythmia, dysfunction of the ventricles or valves, and peripheral embolization during the later stages of development. There is little or no information about right-to-left interatrial shunt with normal pulmonary artery pressure, produced as a consequence of the infiltration of the atrial septum, the right atrial wall, and the myocardium because of the presence of fat in patients with platypnea-orthodeoxia syndrome. We present a patient with this syndrome who was identified through transesophageal echocardiography. The study showed a massive right-to-left shunt without pulmonary hypertension, produced by an important cardiac infiltration of adipose tissue that created a narrow passage in the right atrium, and a redirection of the flow to a patent foramen ovale, explaining the pathophysiology of the syndrome.

Assuntos

Neoplasias Cardíacas/complicações , Comunicação Interatrial/diagnóstico por imagem , Lipoma/complicações , Artéria Pulmonar/diagnóstico por imagem , Idoso , Função do Átrio Direito/fisiologia , Diagnóstico Diferencial , Evolução Fatal , Feminino , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/fisiopatologia , Comunicação Interatrial/etiologia , Humanos , Hipertensão Pulmonar , Hipóxia , Lipoma/diagnóstico por imagem , Lipoma/fisiopatologia , Artéria Pulmonar/patologia , Síndrome , Ultrassonografia

RESUMO

Primary sarcomas of the pulmonary artery and right ventricle are rare, and their presentation is unusual in clinical practice; therefore, their diagnosis is often missed or delayed. The progression of the obstruction from the outflow tract of the right ventricle to the pulmonary artery resembles massive pulmonary embolism. We present a case of one of these tumors which mimicked transesophageal echocardiography (TEE), a massive pulmonary embolism. We conclude that TEE represents a noninvasive method of diagnosis and evaluation when the suspicion is massive pulmonary thromboembolism or a heart tumor.