ventricular septal tumor

Introduction

Introduction to ventricular septal tumor There are two types of ventricular septal tumors: congenital (congenital) and pseudo (acquired). The true membranous tumor or membranous bulge is the capsular sac of the right ventricle. Congenital malformations. Pseudomembranous tumor, also known as tricuspid valve, tricuspid bulge, is a natural phenomenon of ventricular septal defect. basic knowledge The proportion of illness: 0.002% Susceptible people: no special people Mode of infection: non-infectious Complications: endocarditis

Cause

Ventricular septal tumor

(1) Causes of the disease

Early diagnosis of interventricular membranous tumors was associated with endocarditis, but it was not clinically proven. It has been thought to be related to the following factors in the past 10 years:

1. Due to abnormal embryonic development, insufficient interval transfer and insufficient rotation of the aorta, the aorta is slightly right-handed, the membrane is obliquely or horizontally displaced, and the unsupported membrane interval is affected by left ventricular hypertension to produce a tumor-like protrusion. .

2. The membrane compartment interval is abnormal due to the natural closure process, forming a partial weak zone, or the interval lock is slow, but the interventricular septum is still developing, and the left ventricular hypertension causes capsular deformation.

3. The late form of the natural closure of the ventricular septal defect.

(two) pathogenesis

1. True membranous tumor: the fibrous tissue of the ventricular septal membrane is obviously hyperplasia, forming a capsular-like tumor protruding to the right ventricle, after the tricuspid valve is separated, the junction of the anterior anterior valve, even the tricuspid valve is protruding to the right. In the atria, the top of the capsular bag is often accompanied by perforation, and the periphery of the ventricular septum is composed of membrane tissue and fibrous connective tissue.

2. Pseudomembranous tumor: the periphery of the ventricular septum is composed of a septum and/or a anterior flap, and/or a partial chordae, and the rest is a fibrous tissue of the membrane, and there is no capsular wall protruding to the right heart cavity. Part of the tricuspid valve hyperplasia hypertrophy, bulging to the right heart cavity, and sometimes a tricuspid valve-like change.

Prevention

Ventricular septal tumor prevention

1. There is no effective prevention method for this disease. It is necessary to pay attention to strengthening publicity and education, promoting prenatal and postnatal care, guiding scientific pregnancy, strengthening pregnancy care, and avoiding the occurrence of congenital malformations of the fetus.

2. Reasonably arrange the movement of the patient so as not to aggravate the burden on the heart and avoid various complications.

Complication

Ventricular septal tumor complications Complications endocarditis

The disease may have complications such as tumor rupture, obstruction, thromboembolism, and endocarditis.

Symptom

Ventricular septal tumor symptoms common symptoms systolic murmur contraction early Karaoke tremor

Both men and women can develop the disease, but males are more than females, about 2:1. Most patients are prone to upper respiratory tract infections. Children have different degrees of growth and development limitation. A small number of patients can be asymptomatic. The left sternal border 3,4 There are systolic murmurs in the intercostal space II to IV, with tremor, and some patients with P2 hyperthyroidism with early contraction.

Examine

Examination of ventricular septal tumor

1. Electrocardiogram: left axis of the electric axis, left ventricular hypertrophy, a small number of cases are normal or roughly normal.

2. Chest X-ray: mild to moderate congestion in the lungs, straight or full pulmonary artery segment, heart-thoracic ratio 0.48 to 0.62.

3. Echocardiography: showed continuous interruption of the ventricular septum, with membranous tumors, sometimes visible tricuspid regurgitation.

4. Right heart catheterization: confirmed left to right shunt, pulmonary artery pressure is normal or slightly elevated, left ventricular angiography: showing membranous tumor as a capsular-like protrusion to the right heart cavity.

Diagnosis

Diagnostic diagnosis of ventricular septal tumor

diagnosis

Interventricular septal tumors, whether true or false, have clinical symptoms, signs, electrocardiogram, chest X-ray, and even right heart catheterization similar to ventricular septal defect. Preoperative diagnosis mainly relies on echocardiography and left ventricular angiography. Cardiac findings: short-axis heart-to-heart tip and long-axis scan of the heart, showing the complete appearance of the true membranous tumor, apical four-chamber and five-cavity, visible capsular-like protrusion at the proximal septum along the margin of the ventricular systole, In the diastolic phase, the cyst wall and the ventricular septum are flat. The tumor is spherical or conical. The diameter is generally <2.5cm and the length is about 1-2cm. The wall is thin and smooth, the thickness is uniform, the echo is fine, and the pseudomembranous tumor is performed. For semicircular or irregular bulging at the periphery of the ventricular septum, the wall is thicker and the activity is limited. The sulcus occluded lobes slightly protrude to the right or left ventricular outflow or right atrium, sometimes presenting The group echoes the echo, which is located in the middle of the interventricular septum and protrudes to the right ventricular side. It can clearly distinguish the illusion caused by the partial adhesion of the tricuspid valve to the margin of the ventricular septum. The echocardiography is non-invasive and can be repeated, which is beneficial for postoperative follow-up. With the accumulation of experience, not only is there quite a preoperative The diagnosis rate, and can identify true and false membranous tumors and their associated intracardiac malformations and complications, it should be listed as the preferred diagnostic tool, left ventricular angiography traumatic examination, difficult to repeat, and sometimes subject to technical equipment Limitations, but in special cases when left ventricular angiography is required, ascending aorta angiography should be performed to exclude aortic sinus tumors.

Differential diagnosis

Identification of diseases such as ventricular septal defect, aortic sinus tumor.

1. Ventricular septal defect: P2 does not hyperthyroidism, lung congestion and flatness of the pulmonary artery segment are relatively high, which can be used as a clue for the initial diagnosis of membranous tumor. Further identification depends on echocardiography or left ventricular angiography.

2. Congenital aortic sinus aneurysm: no conscious symptoms when not broken, sudden severe chest pain when sinus tumor rupture, with palpitations, difficulty breathing, 3,4 intercostal continuity murmurs on the left sternal border, peripheral vascular signs ( +), if necessary, can be identified by means of echocardiography or retrograde left ventricular ascending aortic angiography.

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