Cardiac tumors natural history: Difference between revisions
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==Natural History== | ==Natural History== | ||
Cardiac tumors can arise in a multitude of ways, resulting in diverse clinical presentations | Cardiac tumors can arise in a multitude of ways, resulting in diverse clinical presentations. Irrespective of cardiac tumor type, cardiac symptoms primarily depend on tumor position and extent. | ||
*Patients may develop systemic symptoms including fever, fatigue, and joint pains. | *Patients may develop systemic symptoms including fever, fatigue, and joint pains. | ||
*Tumors can impede blood flow, causing hemodynamic abnormalities, poor cardiac output, or heart failure. | *Tumors can impede blood flow, causing hemodynamic abnormalities, poor cardiac output, or heart failure. | ||
*Malignant tumors may especially cause weight loss, anorexia, and exhaustion. | *Malignant tumors may especially cause weight loss, anorexia, and exhaustion. | ||
*In addition, valvular disease can lead to stenosis or regurgitation. | |||
*Local infiltration of the cardiac conduction system could result in arrhythmias. | |||
*Non-specific features like pericardial effusion and compression of nearby structures, such as the coronary arteries, might develop. | |||
*Clinically, the tumor type (benign or malignant), anatomical location, time duration of receiving treatment and available treatment options are the most critical clinical criteria in determining a cardiac tumor patient's natural history of disease. | |||
==Complications== | ==Complications== | ||
Revision as of 03:45, 7 July 2022
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2] Dheeraj Makkar, M.D.[3]
Overview
Natural History
Cardiac tumors can arise in a multitude of ways, resulting in diverse clinical presentations. Irrespective of cardiac tumor type, cardiac symptoms primarily depend on tumor position and extent.
- Patients may develop systemic symptoms including fever, fatigue, and joint pains.
- Tumors can impede blood flow, causing hemodynamic abnormalities, poor cardiac output, or heart failure.
- Malignant tumors may especially cause weight loss, anorexia, and exhaustion.
- In addition, valvular disease can lead to stenosis or regurgitation.
- Local infiltration of the cardiac conduction system could result in arrhythmias.
- Non-specific features like pericardial effusion and compression of nearby structures, such as the coronary arteries, might develop.
- Clinically, the tumor type (benign or malignant), anatomical location, time duration of receiving treatment and available treatment options are the most critical clinical criteria in determining a cardiac tumor patient's natural history of disease.
Complications
- Emboli into coronary arteries
- Retrograde flow through cardiac lymphatics
- Direct extension from mediastinum
- Emboli or spread via great veins => endocardial metastases
- Hypernephroma
- Testicular sarcoma
- IVC leiomyosarcoma
- Ovarian cancer
- Colon cancer
Prognosis
The vast majority of the tumors of the heart have a benign course and are not directly fatal. However, even the benign tumors of the heart can be lethal due to either direct extension into the electrical conduction system of the heart (causing complete heart block or a fatal dysrhythmia), or due to emboli from the tumor mass that may have lethal sequelae.
The malignant tumors of the heart have a worse prognosis. Cardiac sarcomas generally lead to death within 2 years of diagnosis, due to rapid infiltration of the myocardium of the heart and obstruction of the normal flow of blood within the heart.[1][2]