CARDIAC TUMOUR

Primary tumours of heart may occur but they are extremely rare. Secondary tumours are relatively common. Of different primary tumours commonest being Myxoma (benign) and Sarcoma (malignant). Angiosarcoma and Rhabdomyosarcoma are common. Secondary tumour may occur from bronchogenic carcinoma, carcinoma form breast, kidney, Kaposi’s sarcoma (in AIDS), lymphoma and malignant melanoma. malignant tumour may have protean manifestations such as obstruction of the chamber, valve orifices and great vessels: pericardial effusion and disturbances of left ventricular function. Cineangiography, CT scan, MRI are helpful in the diagnosis.

Myxoma commonly occurs in left atrium (90%). In 10% of cases they are seen to arise from sites other than left atrium. These tumours are vasoformative neoplasm contain- ing an abundance of mucoid stroma and stellate cells with polymorphic nuclei. 10 % cardiac myxomas have manifesta- tions of malignancy even with metastasis…CARDIAC TUMOUR…. Symptoms may arise from mechanical obstruction by the tumour resulting in intermittent vertigo, syncope, mitral mid-diastolic murmur, even sometimes preceded by an opening like sound (Tumour plop), splitting of first heart sound and accentua- tion of P2. The murmur changes with change of posture and hence examiners often differ in their opinion regarding the character of murmur. This is due to the fact that tumour is located in a long stalk and is usually pedunculated. Some-times murmurs of mitral incompetence or combined steno- sis and incompetence may be audible. Due to increased left atrial pressure, pulmonary venous hypertension and pulmo- nary oedema may result in producing breathlessness. Symp-toms may arise as a result of embolisation (30%) either in systemic circulation or in the pulmonary circulation when the tumour is located in the right side of the heart. Con- stitutional symptoms may also be seen which are possible of immunologic in origin such as anemia, fever, tachycar- dia, high ESR, clubbing, weakness, loss of weight, arthral- gia, myalgia, hyperglobulinaemia, altered liver function tests, Raynaud’s phenomenon, wasting, etc.CARDIAC TUMOUR

Diagnosis is made by cineangiocardiography which may reveal a filling defect and by Echocardiography showing multiple dense echoes in diastole posterior to the anterior mitral leaflet. The last method is usually preferred.CARDIAC TUMOUR

TREATMENT

Operative removal usually results in complete cure but the patient should be followed up because of the chance of recurrence.CARDIAC TUMOUR

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