cardiac tumors

most common benign cardiac tumor on adults, that is usually attached by a stalk to the left side of the intertribal septum

myxoma

most common cardiac valve tumor (15%), mostly found on the aortic valve, located in the LA or RA, cardiac auscultation may contact a low frequency sound occurring after S2 consistent with a tumor plop

papillary fibroelastoma

most common benign cardiac tumor on children/newborns

rhadomyoma

second most common pediatric cardiac tumor

fibroma

a benign tumor that may also be malignant

paragangliomas

pathologies associated with large myxomas

they Amy obstruct blood flow or prolapse into the mitral or tricuspid annulus and mimic stenosis

growth rate for myxoma

1.8 cm per year

symptoms for myxoma

• dyspnea

• dizziness

• syncope

• palpations

• cheat pain

• fever

• weight loss

• joint pain

• clubbing

• malaise

• TIA/CVA

• raynauds

• HF

papillary fibroelastoma is clinically associated with

• dyspnea

• cyanosis

• peripheral/pulmonary emboli

• cerebral vascular accident transient ischemic attack

• visual changes

• transient paresis

• aphasia

• paradoxical embolization

• angina

• myocardial infarction

• HF

• atrioventricular conduction disturbance

  • sudden death

ECHO signs for papillary fibroelastoma

• small, mobile, pedunculate echo dense mass and may be multiple

• mimic the appearance of a vegetation

• no valvular abnormalities, significant regurgitation or stenosis

• TEE is identify and characterize and then TTE for surgical removal

a circumscribed, encapsulated tumor which is usually solitary, intramuscular, subendocardial, sub epicardial, epicardial or rarely may involve the current valve. most frequently located in the LV, RA, or intertribal septum

lipomas

intrapericardial lipomas may cause

pericardial effusion

tumor usually ventricular, intramural and solitary, may be large and may occur in any cardiac chamber but most commonly found embedded in the myocardium the anterior wall of the LV, intraventricular septum or RV

Fibroma

what disease is rhabdomyoma associated with

tuberous sclerosis

most cases of rhabdomyoma is present

in the first year of life

symptoms for rhabdomyoma

• arrhythmia

• AV block

• pericardial effusion

• sudden death

  • may cause obstruction to outflow or inflow

ECHO/doppler findings for rhabdomyoma

• echo dense multiple nodular masses in several chambers or may appear as a single intramural echo dense mass of the intraventricular septum or ventricle free wall

• CW used to evaluate for the presence and severity of outflow and inflow obstruction

• may be detected during a fetal echo exam (case reported at 30 weeks gestation and removed at 20 months of age)

malignant tumor that usually involves the RA

angiosacroma

malignant tumor that often infiltrate ventricular myocardium

rhabdomyosarcoma

clinical presentations for sarcomas

• obstructive symptoms

• arrhythmias

• chest pain

• death

patient with angiosarcommas often present with

• chest pain

• continuous murmur

• Rt heart failure

• pericardial effusion front/tamponade/constriction

• vena canal obstruction

an extra cardiac tumor located in the appendix or ileum but may also occur in the bronchus, biliary tract, pancreas, testis, and ovary. affects the right heart more than the left and most often found on the TV, PV and vena cava, RA RV.

carcinoid heart disease

Doppler findings for carcinoid disease

• TR (most common, often severe)

• heparin vein systolic flow reversal due to significant TR

• dagger shaped TR velocity

• TS which is usually mild

• PR 81%

• valvular pulmonic stenosis with varying degrees of severity

• mild to moderate MR with left heart involvement