Cardiac Masses

Question 1

4 most common mets to heart

Answer 1

melanoma, breast, lung, lymphoma

Question 2

if you see RA mass exending to IVC, what is next best step?

Answer 2

CT/MR to look for primary tumor since this is likely a met

Question 3

most common primary cardiac tumor

Answer 3

myxoma

Question 4

define Carney Syndrome (AD, chrom 2, 17) and associated findings (5)

Answer 4

systemic & recurrent myxomas w/: lentiginosis/blue moles, endocrine dz, thyroid CA, Breast adenomas, testicular CA

Question 5

where does myxoma usually show up?

Answer 5

atrial septum of LA or RA

Question 6

what echo finding will this kid have?

Answer 6

Rhabdomyoma

Question 7

name the benign tumor that is found in LV free wall/apex/septum, often multiple, and has calcifications within it.

Answer 7

fibroma

Question 8

Diagnosis? what would cause a TIA and stroke?

Answer 8

Papillary FIbroelastoma; TIA if platelets embolise from it and stroke if PFE embolizes

Question 9

does a papillary fibroelastoma have a stalk and associated w/ embolism?

Answer 9

yes

Question 10

what has similar pathology to papillary fibroelastoma, increases with age, is a degenerative process of AV>>MV and not associated with embolization?

Answer 10

Lambl’s Excrescence

Question 11

should you surgically remove left-sided papillayr fibroelastoma? why?

Answer 11

yes. embolization.

Question 12

diagnosis?

Answer 12

blood cyst (notice contrast bubbles within it)

Question 13

diagnosis

Answer 13

pericardial cyst

Question 14

diagnosis?

Answer 14

Lipomatous Hypertrophy (Dumbell shape around fossa ovalis)

Question 15

diagnosis?

Answer 15

Eustachian Valve (chiari network)

Question 16

a large eustachian valve = ?

Answer 16

chiari network

Question 17

where does angiosarcome present?

Answer 17

RA/AV groove

Question 18

name 2 cardiac tumors that favor ventricles

Answer 18

Fibroma, rhabdomyoma

Question 19

18 F w/ cushing’s and multiple lentigines. Dx?

Answer 19

myxoma/Carney syndrome (usually in atypical location)

Question 20

echo diagnosis?

Answer 20

Carney syndrome/myxoma (lentigines on face)

Question 21

answer and treatment

Answer 21

PFE, surgical resection since it’s left sided

Question 22

Answer 22

tuberous sclerosis (rhabdomyoma)

Question 23

do you usually resect rhabdomyomas in children?

Answer 23

no, the tumors go away (resect if arrhythmias)

Question 24

most common cardiac tumor in kids?

Answer 24

rhabdomyoma

Question 25

Dx?

Answer 25

Question 26

Diagnosis?

Answer 26

Angiosarcome (RA + Pericardial Effusion, malignant)

Question 27

bloody pericardial effusion + RA mass = ?

Answer 27

angiosarcoma

Question 28

what is this mass in pt w/ Polyarteritis Nodosa?

Answer 28

Coronary Artery Aneurysm in AV groove