Cardiac masses Flashcards
(34 cards)
DDx cardiac mass
Thrombus Vegetation Metastatic Primary neoplasm Artifact
Metastatic cardiac masses
Melanoma, breast, lung most common
Also RCC, lymphoma, carcinoid
Echo metastatic cardiac mass
Mass doesn’t respect tissue planes
>60% pericardial involvement
Primary cardiac neoplasms (malignant)
Leoimyosarcoma Fibrosarcoma Osteosarcoma Rhabdomyosarcoma Angiosarcoma Lymphoma
Leiomyosarcoma
Prefers LA
Smooth muscle cells
MV and PV involvement
Surgical tx +/- chemo/rad
Fibrosarcoma
LA
Fibroblasts
Primary pericardial tumor
Osteosarcoma
LA
Bone producing cells
Calcified mass
Rhabdomyosarcoma
No chamber preference
Younger
Striated muscle cells
Nodular pericardial involvement
Angiosarcoma
Atrial, AV groove, prefer R side Endothelial cells Pericardial extension Very vascular, bloody Usually discovered late 3:1 M:F
Lymphoma
RA
B cell
Pericardial involvement
Benign neoplasms
Myxoma
Rhabdomyoma
Fibroma
Myxoma
LA, RA
Attaches to atrial septum with narrow stalk
Should be resected
Myxoma syndrome
Atypical location
skin, mucosa, cardiac
Famkily history
Carney syndrome
Atypical location of myxoma, endocrine symptoms, pigmented lesions
Rhabdoymyoma
Most common benign in children
A/w tuberous sclerosis
Often multiple, ventricular wall / AV valves
Regress spontaneously
Fibroma
LV fee wall, septum or apex Well demarcated Grows into cavity, may interfere with filling Often multiple CHF, VT
Valvular masses
Papillary fibroelastoma
Lambl’s excresance
Immune mediated vascular disease
Blood cyst
Papillary fibroelastoma echo
Attached by a stalk Any endocardial surface Independent motion Small, 1.0 cm, usually single Shimmering edge Arterial side of semilunar valves, atrial surface of AV valves
Lambl’s excresance
Closure margin of valve
Linear, AV > MV
Increased with age, degenerative
Immune mediated vascular
Malignancy SLE APLS Highly embolic Libman-Sacks
Libman-Sacks
Small, nodule, relatively non-mobile mass on valve closure plane
Blood cyst
Thin walled, multi-lobed, cystic
Attachment to valve leaflet
Echo Lucent core
AV groove masses
Pericardial cyst
Lipomatous hypertrophy
Coronary artery aneurysm
Pheochromocytoma
Pericardial cyst
No contrast, benign
Right AV groove, diaphragm
Clear center, fluid filled
Continuous with pericardium
