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Cardiac Tumors - goodman
#1

Tumors metastatic to the heart (e.g. mesothelioma, melanoma) are more common than primary cardiac tumors.

Cardiac metastases most commonly involve the pericardium; thus, patients can initially present with manifestations of tamponade (e.g. hypotension, distended neck veins, distant heart sounds) secondary to a neoplastic pericardial effusion.

Myxoma: Most common primary cardiac tumor in adults. Forms a pedunculated mass in the left atrium 90% of the time.

Clinical manifestations of cardiac myxomas include:
• Syncope*
• Embolization (e.g. stroke)
• Constitutional symptoms (e.g. fatigue fever, weight loss)

*Myxomas create an obstructive “ball-valve” effect that blocks the mitral orifice, leading to decreased left ventricular filling and cardiac output.

An early diastolic murmur known as a “tumor plop” is characteristic of atrial myxoma.

Histologically, myxomas are composed of stellate cells within a mucopolysaccharide matrix containing abundant inflammatory and endothelial cells.


Rhabdomyoma: Most common primary cardiac tumor in children. It is a benign tumor of striated muscle.

Associated with tuberous sclerosis

Like cardiac myxomas, cardiac rhabdomyomas can also cause syncopal episodes.


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