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Cardiac Tumors

Abnormal cell reproduction can cause tumors to grow in the heart or the pericardium which surrounds the heart. These tumors are either benign or malignant in nature. However, the majority of cardiac tumors are benign, or non-cancerous.

Benign Tumors

Because the heart is such an essential organ, even benign tumors can be life-threatening. There are six types of benign tumors:

• Myxomas usually occur in the left atrium and are the most common type of tumor inside the heart. Left untreated, these tumors can interfere with the function of cardiac valves; they can obstruct blood flow, and small fragments of tumors can break off and travel through the bloodstream to become lodged in the lungs or other parts of the body. Symptoms of myxoma may include:

    • Emboli in which pieces of the tumor travel through the blood stream and cause clots or blockages
    • Blockage of the blood flow at the opening of one of the heart valves 

• Rhabdomyomas develop in the myocardium or the endocardium and generally occur in children or infants. They are associated with tuberous sclerosis, adenoma sebaceum of the skin, kidney tumors and arrhythmias.

• Fibroma tumors occur on the valves of the heart and may be related to inflammation.

Cardiac symptoms of rhabomyomas and fibromas include:

• Blockages of blood flow

• Rapid heart beats

• Enlargement of the heart

• Signs of a blockage to the flow of blood out of the ventricles

• Heart murmurs

• Lipomas or fatty tumors

Malignant Cardiac Tumors

While still rare, cardiac sarcoma is the most common malignant cardiac tumor and usually begins in the right atrium of the heart or on the pericardium. Another type, angiosarcomas occur inside the heart’s chamber and can obstruct the flow of blood in and out of the right atrium. This obstruction may cause swelling of the feet, legs, ankles, and/or abdomen, and distension of the neck veins. Angiosarcomas on the pericardium can cause chest pain, shortness of breath, fatigue, and palpitations. Other cancerous tumors of the heart include:

• Fibrosarcoma

• Liposarcoma

• Rhabdomyosarcoma

Tumors which have spread to the heart from another part of the body may have the following symptoms:

• Sudden enlargement of the heart

• Bizarre changes in the shape of the heart on a chest x-ray

• A blockage

• Irregular heart rhythms

• Unexplained heart failure

Symptoms of cancerous cardiac tumors which originate in the heart may include:

• Sudden heart failure

• A rapid accumulation of bloody fluid in the lining around the heart, often with a blockage of the blood flow in the heart

• Various kinds of arrhythmias

Diagnosing Cardiac Tumors

There are a number of ways to diagnose cardiac tumors. In addition to obtaining your complete medical history and performing a physical exam, your doctor will choose a diagnostic tool that best matches the symptoms you are experiencing. These tools include:

• Echocardiogram - a noninvasive ultrasound of the heart

• Electrocardiogram (ECG) – a noninvasive test to record the electrical activity of the heart

• Computed Tomography (CT or CAT scan) - a diagnostic imaging procedure which shows detailed images of bones, muscles, fat, and organs

• Magnetic Resonance Imaging (MRI) - a diagnostic imaging test that looks at organs and structures within the body

• Chest x-ray

• Coronary arteriogram (or angiogram) - with this procedure, x-rays are taken after a contrast agent is injected into an artery - to locate the narrowing, occlusions, and other abnormalities of specific arteries

Treatment for Cardiac Tumors

Specific treatment for cardiac tumors will be determined by your physician and based on:

• your age, overall health, and medical history

• extent of the disease

• your tolerance for specific medications, procedures, or therapies

• expectations for the course of the disease

• your opinion or preference

Benign cardiac tumors that are small and cause no symptoms may in some cases be closely monitored, and may require no treatment. However surgery is indicated in most cases to both make a diagnosis of cell type and to keep the tumor from growing and causing either obstruction to blood flow or rhythm disturbances. Malignant heart tumors are removed through open heart surgery.

In all cases, a patient’s prognosis depends on the type of tumor, its size, and location.

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