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INTRODUCTION

ESSENTIALS OF DIAGNOSIS

  • A rare but critical diagnosis in the evaluation of cardiac masses.

  • The history, physical examination, and imaging characteristics can yield valuable diagnostic clues.

  • Diagnostic confirmation requires tissue biopsy.

GENERAL CONSIDERATIONS

Cardiac tumors, although considered a rare diagnostic entity, provide unique insight into the anatomic and pathophysiologic functioning of the heart. Reminiscent of benign, malignant, and metastatic neoplasms elsewhere in the body, theses tumors herald their presence by the secondary effects produced from enlarging within the confines of cardiac chambers and tissues. Because they rarely cause symptoms, cardiac tumors are generally unsuspected and may be discovered incidentally during evaluation of an unrelated condition. This chapter will help guide the astute clinician, focusing on when to consider this diagnosis and how to obtain the appropriate cardiovascular imaging studies. There are a wide variety of common cardiac tumors (Table 32–1).

Table 32–1.Classification of Common Cardiac Tumors

PRIMARY CARDIAC TUMORS

Primary tumors of the heart are rare, with a prevalence of 0.02% reported in combined data from multiple large autopsy series. Although cardiac myxoma has been traditionally reported as the most frequent tumor type in adults, increasing utilization of imaging studies has revealed a higher frequency of papillary fibroelastomas than previously known. In the pediatric population, rhabdomyomas represent the most common type of primary cardiac tumor (Table 32–2).

Table 32–2.Primary Cardiac Tumors: Location and Features

A. Benign Cardiac Tumors

The overwhelming majority of primary cardiac tumors, approximately 75% to more than 90%, are benign, and may arise ...

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