Malignant Tumors

malignant

cancerous

Sarcoma is the most common

primary cardiac MALIGNANT tumor

Angiosarcoma is the most common

Sarcoma

Angiosarcoma begins on the

pericardium or RA and Can Embolize

RA Angiosarcoma Creates

inflow/outflow obstructions causing a backup of venous return

RA Angiosarcoma symptoms

Feet swelling, lower extremity edema, abdominal distention and distended neck veins

Pericardial Angiosarcomas can cause

Pericardial effusion/tamponade

Autotransplantation

the heart is removed then the tumor is removed and the heart is placed back into the pt

in Angiosarcoma

80% metastasize

Secondary Metastatic Tumor are

More common than primary malignant tumors

Secondary Metastatic Tumors appears during the

terminal stage

Secondary Metastatic Tumor usually metastasize from

breast, lung or renal carcinomas/malignant melanomas

Right atrium

most likely involved in metastatic tumors

First indication of metastatic cardiac disease

pericardial effusion

Lung cancer can reach the heart from the

PV4 traveling into the LA

pericardial metastatic starts in the

Pericardium then moves into the Myocardium -> Endocardium

RA metastatic can be from a

Renal/adrenal, liver or uterine carcinoma/melanoma or Wilms tumor that enters through the IVC

metastatic enters the R heart through the

IVC

Carcinoid Heart Disease Originates from a

metastasizing carcinoid tumor (usually from the appendix or ileum) that secretes serotonin

If liver metastasis occurs

serotonin deposits into the endocardial lining of the R heart

Serotonin does not travel to the

L heart since the pulmonary endothelium removes/metabolizes serotonin in venous blood

Carcinoid Heart Disease Sonographic Findings

TV Leaflets are fixed (doesnt open/close well), severe TR and R HF

Extracardiac Tumors

occurs anywhere within the heart

common with Extracardiac Tumors

Pericardial involvement

LV Thrombi

forms in akinetic/dyskinetic apical areas and is associated with anterior MIs

types of LV thrombi

single/Layered, Multilobulated or Pedunculated

LA Thrombus is associated with

MS, LAE and Afib

If patient is in Afib rule out

LA/LAA thrombus prior to cardioversion

embolization symptoms

respiratory distress

thymoma or esophageal carcinomas can reach the heart through the

Lymphatic system

Extracardiac Tumor examples

thymoma, teratoma or infradiaphragmatic tumor