Lecture 17: Intracardiac Masses Flashcards
How are cardiac tumors classified?
Anatomic location and size
What is the hallmark sign of an endocardial cardiac tumor?
Thromboembolism
What characterizes a valvular cardiac tumor?
- Valvular damage, obstruction or regurg
- CHF
- Sudden death or syncope
What characterizes a pericardial cardiac tumor?
- Pericarditis
- Pericardial effusion
- Arrhythmias
- Tamponade
- Constriction
What characterizes a myocardial pericardiac tumor?
- Arrhythmias, ventricular or atrial
- Conduction abnormalities
- EKG changes
- Systolic or diastolic LV dysfunction
- Coronary involvement: angina, infarction
What is the imaging modality of choice for diagnosing cardiac tumors?
Cardiac MRI/gated CT
What is the main weakness of using echos to find cardiac tumors?
Cannot detect ventricular wall tumors
What is the mainstay of treatment for cardiac tumors?
Surgical excision
How do most primary tumors of the heart present?
Benign
What is the MC benign primary cardiac tumor in kids?
Rhabdomyomas
What is the MC primary cardiac tumor in adults?
Cardiac myxomas
Papillary fibroelastoma is increasing tho
When are most cardiac myxomas found?
30-60
Sporadic and isolated
Describe a cardiac myxoma.
- Pedunculated and gelatinous in consistency
- Friable or villous = high embolus risk
- Larger = obstruction CV symptoms
Where is the MC location of a primary cardiac myxoma to be found?
Left atrium
What is the classic finding for a primary cardiac myxoma?
Tumor plop (slightly earlier than S3)
Early diastolic heart sound that probably needs an echo.
How is a primary cardiac myxoma diagnosed and treated?
- Diagnosis: Echo or Pathology
- Tx: Excision (need f/u echo d/t high rate of recurrence)
When are papillary fibroelastomas typically found?
> 60 y/o
Where does a papillary fibroelastoma tend to appear?
MC on the left sided valves, mainly AV
Looks like a sea anenome or dandelion
What are the clinical manifestations of a papillary fibroelastoma?
- Cerebral embolism
- Myocardial infarction
- Sudden death
- PE
- Syncope
How do primary cardiac lipomas usually look like?
Solitary, circumscribed, encapsulated tumor found in the subendocardium protruding into the cardiac chamber
When are primary cardiac fibromas usually found?
Pediatric population (2nd MC benign in children after rhabdomyomas)
Where do primary cardiac fibromas tend to appear?
Ventricular myocardium, esp in the anterior wall of the LV or interventricular septum.
What are most S/S of a fibroma due to?
Mass effect (it is huge and NOT encapsulated)
Hard to resect since not encapsulated
What is the MC benign cardiac tumor in children?
Rhabdomyomas (prior to age 1 usually)
