Cardiac tumors physical examination
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Physical Examination
Auscultation
Heart Sounds
- Prolapsing of atrial tumor into the mitral valve orifice results in delay in closure of mitral valve producing a loud S1.
- There is a delay in P2, intensity of which depends on the absence or presence of pulmonary hypertension.
- Atrial tumor striking against the endocardial wall may produce an early diastolic sound known as the tumor plop.
- In some cases S3 and S4 may also be present.
Murmur
- In case of obstruction of mitral valve by the atrial tumor, a diastolic atrial rumble is heard.
- If atrial tumor results in damaging of the mitral valves leading to mitral regurgitation then a systolic murmur is heard at the cardiac apex.
- In case of right atrial tumor, a diastolic rumble due to obstruction of the tricuspid valve and a holosystolic murmur due to tricuspid regurgitation may be present.
Syndromes associated with Cardiac Tumors to be cognizant of during the Physical Examination
- NAME syndrome: It refers to:
- nevi,
- atrial myxoma,
- myxoid neurofibroma, and
- ephelides (i.e., freckles [tanned macules found on the skin])
- LAMB syndrome: It refers to:
- lentigines,
- atrial myxoma, and
- blue nevi