A previously healthy 76-year-old woman was assessed preoperatively prior to hip arthroplasty. Cardiac examination was notable for a mid-diastolic murmur at the apex—appreciable only in the supine position. She had no signs or symptoms of heart failure. The patient's N-terminal-pro-B-type natriuretic peptide blood concentration was normal (71 pg/mL). A transthoracic echocardiogram showed preserved biventricular systolic function, unimpaired diastolic relaxation, normal left atrial dimensions free of any intra-atrial septation, and no valvular abnormalities. However, both apical four-chamber and short-axis views showed evidence of extrinsic compression of the left atrium ( ; ). A subsequent CT scan identified large, beaked, osseous outgrowths from the thoracic spinal bodies T7 to T10 that were directly compressing the heart's left atrium ( ; ). No intervention was recommended in view of the patient's asymptomatic clinical status and she was medically cleared for the orthopaedic surgery.

中文翻译：

---

脊柱骨赘压迫左心房外部

在髋关节置换术前，对一名先前健康的76岁女性进行了术前评估。心脏检查发现心尖舒张中期杂音-仅在仰卧位置才可观察到。她没有心力衰竭的迹象或症状。患者的N端前B型利尿钠肽血浓度正常（71 pg / mL）。经胸超声心动图显示保留的双心室收缩功能，舒张舒张期不受损害，左心房尺寸正常，无心房分隔，无瓣膜异常。然而，无论是心尖四腔还是短轴视图均显示左心房外在压迫的证据（;）。随后的CT扫描确定了从胸椎T7至T10的大的喙状骨性增生物，它们直接压迫了心脏的左心房（; ）。考虑到患者的无症状临床状况，建议不进行干预，并且她已经接受了整形外科的医学许可。