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Echo > Cardiac masses > Flashcards

Cardiac masses Flashcards

1
Q

DDx cardiac mass

A 
Thrombus
Vegetation
Metastatic
Primary neoplasm
Artifact
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2
Q

Metastatic cardiac masses

A

Melanoma, breast, lung most common

Also RCC, lymphoma, carcinoid

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3
Q

Echo metastatic cardiac mass

A

Mass doesn’t respect tissue planes

>60% pericardial involvement

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4
Q

Primary cardiac neoplasms (malignant)

A 
Leoimyosarcoma
Fibrosarcoma
Osteosarcoma
Rhabdomyosarcoma
Angiosarcoma
Lymphoma
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5
Q

Leiomyosarcoma

A

Prefers LA
Smooth muscle cells
MV and PV involvement
Surgical tx +/- chemo/rad

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6
Q

Fibrosarcoma

A

LA
Fibroblasts
Primary pericardial tumor

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7
Q

Osteosarcoma

A

LA
Bone producing cells
Calcified mass

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8
Q

Rhabdomyosarcoma

A

No chamber preference
Younger
Striated muscle cells
Nodular pericardial involvement

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9
Q

Angiosarcoma

A 
Atrial, AV groove, prefer R side
Endothelial cells
Pericardial extension
Very vascular, bloody
Usually discovered late
3:1 M:F
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10
Q

Lymphoma

A

RA
B cell
Pericardial involvement

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11
Q

Benign neoplasms

A

Myxoma
Rhabdomyoma
Fibroma

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12
Q

Myxoma

A

LA, RA
Attaches to atrial septum with narrow stalk
Should be resected

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13
Q

Myxoma syndrome

A

Atypical location
skin, mucosa, cardiac
Famkily history

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14
Q

Carney syndrome

A

Atypical location of myxoma, endocrine symptoms, pigmented lesions

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15
Q

Rhabdoymyoma

A

Most common benign in children
A/w tuberous sclerosis
Often multiple, ventricular wall / AV valves
Regress spontaneously

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16
Q

Fibroma

A 
LV fee wall, septum or apex
Well demarcated
Grows into cavity, may interfere with filling
Often multiple
CHF, VT
17
Q

Valvular masses

A

Papillary fibroelastoma
Lambl’s excresance
Immune mediated vascular disease
Blood cyst

18
Q

Papillary fibroelastoma echo

A 
Attached by a stalk
Any endocardial surface
Independent motion
Small, 1.0 cm, usually single
Shimmering edge
Arterial side of semilunar valves, atrial surface of AV valves
19
Q

Lambl’s excresance

A

Closure margin of valve
Linear, AV > MV
Increased with age, degenerative

20
Q

Immune mediated vascular

A 
Malignancy
SLE
APLS
Highly embolic
Libman-Sacks
21
Q

Libman-Sacks

A

Small, nodule, relatively non-mobile mass on valve closure plane

22
Q

Blood cyst

A

Thin walled, multi-lobed, cystic
Attachment to valve leaflet
Echo Lucent core

23
Q

AV groove masses

A

Pericardial cyst
Lipomatous hypertrophy
Coronary artery aneurysm
Pheochromocytoma

24
Q

Pericardial cyst

A

No contrast, benign
Right AV groove, diaphragm
Clear center, fluid filled
Continuous with pericardium

25
Q

Lipomatous hypertrophy

A

Right AV groove, atrial septum
Can be extensive
Dumbbell appearance, fossil ovalis preserved
Usually benign, no sx

26
Q

Pheochromocytoma

A

Right AV groove

Well demarcated, own blood supply

27
Q

Class I echo for mass

A

Clinical syndrome suggesting mass
Follow-up after surgery if likely to recur
Treatment depends on echo
Malignancy assessing for cardiac involvement and staging

28
Q

Class IIb echo for mass

A

Screening for disease state likely to result in mass formation without clinical evidence of mass

29
Q

Myxoma symptoms

A

Intracardiac obstruction - dyspnea, syncope, palps
Systemic embolization
Constitutional symptoms

30
Q

Synovial sarcoma

A

Translocation between chromosome 18 and the X chromosome

Malignant primary cardiac sarcoma, very rare, poor prognosis

31
Q

Chiari network

A

Remnant of right valve of sinus venosus
Fibers in RA from IVC orifice
2-3% normal hearts

32
Q

Pericardial cyst CXR

A

May be seen on CXR with rounded mass along right heart

33
Q

Papillary fibroelastoma surgery indication

A

Embolic events
Events due to tumor mobility (coronary postal occlusion)
Highly mobile or late >1 cm

34
Q

Metastatic melanoma

A

Most commonly charcoal heart - tumors studding pericardium

Can also be solid intracardiac mass

Echo (30 decks)

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