Cardiac Masses Flashcards
What are cardiac masses?
Cardiac masses are very rare
What is the most common type of cardiac tumors?
Primary benign tumors
Primary benign tumors account for 80% of all cardiac tumors.
What are the two categories of malignant cardiac tumors?
Primary & secondary malignant tumors
What risk do all intracardiac masses pose?
All intracardiac masses can be a source of embolism
Fill in the blank: Cardiac masses can lead to a _______.
brain attack or stroke
What does benign mean?
Noncancerous
Benign tumors do not invade nearby tissues or spread to other parts of the body.
What is a myxoma?
Soft tumor made up of gelatinous connective tissue
Myxomas are typically benign and can occur in various locations, including the heart.
What characterizes a fibroelastoma?
Fibroelastic soft tissue containing round or ragged, elastic fiber fragments
Fibroelastomas are often found in the heart and are generally benign.
Define fibroma.
Tumors that are composed of fibrous or connective tissue
Fibromas can occur in various organs and are usually benign.
What does malignant mean?
Cancerous
Malignant tumors can invade nearby tissues and spread to other parts of the body.
What is a sarcoma?
Malignant tumor of connective tissue
Sarcomas can arise in bones, muscles, fat, and other connective tissues.
What is angiosarcoma?
Cancer that develops in the inner lining of blood vessels and lymph vessels
Angiosarcoma is a rare type of cancer that can occur in various locations.
What is osteosarcoma?
Malignant tumor of bone
Osteosarcoma is the most common type of bone cancer, often occurring in teenagers and young adults.
What is rhabdomyosarcoma?
Malignant tumor involving striated muscle tissue
Rhabdomyosarcoma is the most common soft tissue sarcoma in children.
What is fibrosarcoma?
Tumor of stem cells/bone marrow that can occur as a soft-tissue mass
Fibrosarcoma is a malignant tumor that can arise in various locations and is often aggressive.
What is Atrial Myxoma?
A benign tumor of connective tissue containing mucous or gelatinous material.
What percentage of benign tumors in adults does Atrial Myxoma represent?
80% overall, 50% in adults.
Where is Atrial Myxoma most commonly located?
In the atria, with the left atrium (LA) being the most common.
How is Atrial Myxoma attached to the heart?
Attached to the interatrial septum (IAS) by a stalk.
What can large Atrial Myxomas mimic?
Mitral Stenosis (MS) due to obstruction.
What are common symptoms of Atrial Myxoma?
Fever, shortness of breath (SOB), embolic event.
Is surgery indicated for Atrial Myxoma?
Yes, surgery is always indicated.
What should one do when encountering an Atrial Myxoma?
Don’t panic and ALWAYS hold composure.
What is the second most common primary cardiac tumor?
Papillary Fibroelastomas
Most common valvular tumor.
What is the most common type of tumor found on heart valves?
Papillary Fibroelastomas
It is the second most common primary cardiac tumor.
What is the typical appearance of Papillary Fibroelastomas on imaging?
Commonly circular and hyperechoic
This characteristic helps in identifying the tumor.
Are Papillary Fibroelastomas often symptomatic or asymptomatic?
Often incidental finding; many are clinically silent
They can result in emboli such as stroke.
What potential complication can arise from Papillary Fibroelastomas?
Emboli (stroke)
This can occur even if the tumor is clinically silent.
What is the main treatment option for Papillary Fibroelastomas?
Anticoagulation and surgical excision
These treatments help manage the risks associated with the tumor.
What is Lipomatous Hypertrophy of the IAS?
The result of the accumulation of excess adipose tissue within the IAS with sparing of the fossa ovalis membrane
Lipomatous Hypertrophy typically occurs in the interatrial septum.
What are the characteristic appearances of Lipomatous Hypertrophy of the IAS?
Characteristic ‘dumbbell’ or ‘hourglass’ appearance
These shapes are indicative of the distribution of adipose tissue.
What are Rhabdomyomas?
Most common benign tumor in children
Rhabdomyomas are primarily found in the heart and are associated with various conditions.
What condition is strongly associated with Rhabdomyomas?
Tuberous sclerosis
Tuberous sclerosis is a genetic disorder that causes noncancerous tumors to form in many different organs.
Where are Rhabdomyomas typically found?
In the ventricular walls, especially the right ventricle
This location is critical as it can influence heart function.
Are Rhabdomyomas usually singular or multiple?
Usually multiple tumors
The presence of multiple tumors can complicate diagnosis and treatment.
What potential complication can Rhabdomyomas cause?
Outflow tract obstruction
This obstruction can lead to significant cardiovascular issues depending on the severity.
What type of tumors are more common than primary malignant tumors?
Non-Primary Metastatic Tumors
From which organs do non-primary metastatic tumors most frequently travel?
They most frequently travel from lung, breast, kidney, liver, lymph nodes, and melanoma
How do non-primary metastatic tumors spread?
They spread by lymphatic channels, direct venous extension, or through biologically active substances (Carcinoid)
What is the most commonly affected area by non-primary metastatic tumors?
The pericardium
True or False: Non-primary metastatic tumors can only affect the heart.
False
Fill in the blank: Non-primary metastatic tumors may also be _______.
extracardiac
What percentage of primary malignant tumors do sarcomas represent?
28%
What is angiosarcoma associated with?
RA or pericardium
Osteosarcoma is primarily located in which area?
LA
What percentage of primary malignant tumors does rhabdomyosarcoma account for?
11%
What percentage of primary malignant tumors does fibrosarcoma represent?
8%
What are 2D artifacts in ultrasound?
Ultrasound may produce artifacts that give the appearance of masses within the heart.
Artifacts can mislead interpretations and require careful analysis.
Can most ultrasound artifacts be resolved?
Yes, most artifacts can be resolved.
Understanding how to address artifacts is essential for accurate diagnosis.
What is one method to reduce miss-interpretation of ultrasound images?
Image from multiple planes.
Imaging from different angles can help clarify the presence of true structures.
How can using higher frequency transducers help in ultrasound imaging?
It can reduce miss-interpretation of artifacts.
Higher frequency transducers provide better resolution, which can help distinguish between artifacts and actual masses.
What imaging technique can be used to interrogate suspected artifacts?
Color flow Doppler.
Color flow Doppler helps visualize blood flow and can clarify ambiguous findings.
What is one way to potentially improve ultrasound image quality related to patient conditions?
Change patient breathing.
Patient movement can affect image clarity; adjusting breathing can help stabilize images.
What does UEA stand for in the context of ultrasound?
UEAs stand for echo-contrast agents.
Echo-contrast agents enhance the visualization of structures in ultrasound imaging.
What is the sensitivity of TTE to detect LV thrombus?
75-95%
TTE stands for transthoracic echocardiography.
What conditions are associated with LV thrombus?
Myocardial infarction and dilated cardiomyopathy
These conditions can lead to akinesis of the apex.
Can LV thrombus be multiple and mobile?
Yes
This characteristic may increase the risk of embolism.
How does the texture of LV thrombus compare to myocardium?
Texture usually distinct from myocardium
This distinction can aid in diagnosis.
What are the risk factors for embolism related to LV thrombus?
Large size, mobility, and protrusion into LV cavity
These factors can increase the likelihood of embolic events.
What imaging technique is used to follow LV thrombi over time?
TTE (transthoracic echocardiography)
TTE is a non-invasive method used for monitoring.
What is endocarditis?
Endocarditis is an infection or inflammation of the inner lining of the heart.
What attracts micro-organisms in endocarditis?
Micro-organisms are attracted to abnormal valves or areas of turbulent flow.
Can endocarditis occur on foreign devices?
Yes, endocarditis can also occur on foreign devices in the heart.
What are the two types of endocarditis?
Endocarditis can be infectious or non-infectious.
What are common echo findings in endocarditis?
Echo findings can appear thickened, shaggy or pedunculated.
Where do vegetations appear in endocarditis?
Vegetations appear on the flow side of valves.
What is unique about the motion of vegetations in endocarditis?
The motion of vegetations is independent of valves.
What can old (healed) vegetations appear as on an echo?
Old (healed) vegetations can be echogenic in appearance.
What is endocarditis usually associated with?
Endocarditis is usually associated with regurgitation.
