Cardiac tumors natural history
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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
- 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.
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]