JACC. Case reports · 2026
Blunt Trauma-Induced Atrial Fibrillation as First Sign of an Unspecified Cardiac Hemangioendothelioma.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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van Dinter Stefan R, Maathuis Hugo, Verkroost Michel W A, Flucke Uta E, Nijveldt Robin, Verhagen Ad F T M
Аннотация
BACKGROUND: Hemangioendotheliomas are rare vascular tumors comprising different entities, and cardiac localization has been seldom reported.
CASE SUMMARY: A 40-year-old man presented with atrial fibrillation after blunt chest trauma. Subsequent transthoracic echocardiography revealed a large right atrial mass. Cardiac magnetic resonance imaging and positron emission tomography-computed tomography showed a nonmetastatic 76 × 76-mm tumor obstructing inflow and encasing the right coronary artery (RCA). Biopsy suggested a mesenchymal neoplasm. Radical resection of the right atrium and RCA was performed, with reconstruction using a bovine pericardial patch and a saphenous vein interposition graft. Histopathology confirmed a hemangioendothelioma without a definitive subtype. Recovery was uneventful, with restored cardiac function and no recurrence for 5 years.
DISCUSSION: Management according to sarcoma principles favors complete resection. Overall survival is poor, especially in patients with metastatic disease. This case is notable for trauma-associated atrial fibrillation, oncologic RCA resection, and venous graft reconstruction.
TAKE-HOME MESSAGES: Radical resection with coronary reconstruction is feasible. Unexplained, possibly smartwatch-detected arrhythmias after trauma warrant structural evaluation.
CASE SUMMARY: A 40-year-old man presented with atrial fibrillation after blunt chest trauma. Subsequent transthoracic echocardiography revealed a large right atrial mass. Cardiac magnetic resonance imaging and positron emission tomography-computed tomography showed a nonmetastatic 76 × 76-mm tumor obstructing inflow and encasing the right coronary artery (RCA). Biopsy suggested a mesenchymal neoplasm. Radical resection of the right atrium and RCA was performed, with reconstruction using a bovine pericardial patch and a saphenous vein interposition graft. Histopathology confirmed a hemangioendothelioma without a definitive subtype. Recovery was uneventful, with restored cardiac function and no recurrence for 5 years.
DISCUSSION: Management according to sarcoma principles favors complete resection. Overall survival is poor, especially in patients with metastatic disease. This case is notable for trauma-associated atrial fibrillation, oncologic RCA resection, and venous graft reconstruction.
TAKE-HOME MESSAGES: Radical resection with coronary reconstruction is feasible. Unexplained, possibly smartwatch-detected arrhythmias after trauma warrant structural evaluation.