We present an educational case of an 85 y/o woman who repeatedly presented to peripheral hospitals and our tertiary care center with dyspnea on exertion and atypical chest pain, raising suspicion for chronic heart failure, acute coronary syndrome, and pulmonary embolism, respectively.
In the course of her disease she underwent multiple imaging studies, including chest-xray (Fig 1: A: 3 years ago, B: 3 months ago, C: now), coronary angiography (Fig 1: D), computed tomography angiography (CTA, Fig 1: E), echocardiography (Fig 1: F), and cardiac magnetic resonance (CMR, Fig 2: A-D), which revealed a cardiac mass.
Finally, the diagnosis of a malignant cardiac tumor was made using CMR. The diagnosis of an undifferentiated sarcoma was confirmed histologically (Fig 2: E-F).
Cardiac tumors are relatively rare. Making the diagnosis is often a challenge, given a broad spectrum of clinical presentations that range from asymptomatic through dyspnea and chest pain to sudden cardiac death. The diagnosis of a cardiac mass is typically made utilizing a combination of multiple imaging studies. The aim of this case report is to raise awareness of cardiac masses and to point out the hints towards such a mass on different imaging studies. An increase in heart size on chest x-rays, visualization of abnormal vessels on coronary angiography, or a calcified mass on echocardiography and CTA should raise suspicion of a cardiac tumor. Moreover, the vital role of CMR in making the diagnosis of a cardiac tumor is highlighted.
cardiac mass – cardiac tumor – cardiac sarcoma – sarcoma – magnetic resonance imaging – MRI – cardiac MRI – cardiovascular MRI – thoracic CT – echocardiography – coronary angiography – chest x-ray – multimodal imaging
MeSH terms: Cardiac Tumor – Cardiac Tumors – Heart Tumor – Cardiac Neoplasm – Neoplasms, Cardiac – Primary Cardiac Tumors – Intracavitary Tumors of the Heart – Myocardial Tumors
Tuesday, 28 February 2017
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