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Cardiology > Intracardiac Masses > Flashcards

Intracardiac Masses Flashcards

1
Q

Symptoms of heart tumor

A

Typically show symptoms or PE suggestive

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2
Q

Essential of diagnosis of heart tumor

A

Tissue biopsy

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3
Q

What is the MC type of cardiac tumor?

A

Metastatic

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4
Q

Endocardial tumor clinical manifestation

A

Thromboembolism

cerebral, coronary, pulmonary, systemic
Cavitary obliteration or outflow tract obstruction
Valve obstruction and valve damage
Constitutional manifestations¹

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5
Q

Common symptoms of cancer

A

Fever, night sweats, fatigue

constitutional symptoms

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6
Q

What tumor can lead to sudden death or syncope and why?

A

Valvular damage, obstruction, or regurgitation
Congestive heart failure

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7
Q

Pericardial tumors can cause

A

Pericarditis
Pericardial effusion
Arrhythmias
Tamponade
Constriction

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8
Q

Myocardial tumors can cause

A

Arrhythmias, ventricular or atrial
Conduction abnormalities
Electrocardiographic changes
Systolic or diastolic left ventricular dysfunction
Coronary involvement: angina, infarction

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9
Q

What do you sometimes see on cxr for for cardiac tumors

A

abnormal cardiac contour on CXR

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10
Q

gated CT

A

watch cardiac cycle and take images at the correct time

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11
Q

Diagnostic imaging of choice for cardiac tumors

A

Cardiac MRI/gated CT¹

diagnostic procedure of choice for all cardiac tumors

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12
Q

Mainstay management of cardiac tumors

A

Surgical excision

Some tumors may require radiation or chemotherapy

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13
Q

Why is cardiac transplant not common for cardiac tumors

A

Poor prognosis = poor candidate for excision

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14
Q

MC benign primary tumors in adults?
MC benign primary tumor in kids?

A

Adults: Cardiac myxoma MC also papillary fibroelastomas

Kids: Rhabdomyomas

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15
Q

What do cardiac myxomas look like and where are they often found?

A

Mushroom: pedunculated, friable (can break off and go to the rest of the body)

Found in 50 yo
sporadic and isolated
present with obstructive CV symptoms (stroke symptoms, left atrial mass)

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16
Q

What is the heart sound heard in myxocma and why?

A

Tumor falls into LV during dyastolic filling

tumor plop
An early diastolic extra heart sound

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17
Q

Diagnosis modality of choice for myxomas

A

echo or pathology of embolic material

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18
Q

Definitive treatment of myxomas

A

surgical excision with serial echos d/t high likelyhood of recurrence

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19
Q

Shape of papillary fibroelastomas

A

sea anemone, finger like projections on the valve

risk of clotting!

20
Q

Typical patient of papillary fibroelastoma

A

> 60 yo

often found postmortem

21
Q

MC valve of papillary fibroelastoma

A

MC left-sided valves, AV>MV

22
Q

Primary cardiac Lipoma

A

Solitary, circumscribed, encapsulated tumors with a wide range of size and weight

23
Q

MC location of lipoma

A

Subendocardial protruding into cardiac chamber (MC)
Arise in epicardial space and grow into the pericardial space
Intramyocardial lesion

24
Q

Shape of lipoma?

A

Dumbell shape

25
Q

MC demographic of fibroma and complication

A

Children (75% of the time)

Often get large and decrease BF in LV

26
Q

MC chamber of the heart for fibroma

A

ventricular myocardium

27
Q

characteristics of fibroma

A

Typically large in size; 4 to 7 cm
Not distinctly encapsulated, unlike lipomas
Makes complete resection challenging
Result in symptoms of heart failure, ventricular arrhythmias, and sudden death due to mass effect

28
Q

Patient population of Rhabdomyoma

A

typically before 1 year

even before being born

no treatment

often more than one

not a big deal because of sponataneous regression

29
Q

Malignant primary cardiac tumors end route

A

have the root -sarcoma

30
Q

Characteristics of sarcoma

A

50–75% of all primary cardiac malignancies
MC malignant cardiac tumors in adults
Most common in patients 20-49

31
Q

MC type of sarcoma?

A

Angiosarcomas

32
Q

By the time you pick up a cardiac sarcoma, what can you bet?

A

It has metastasis

VERY poor prognosis worse than pancreatic cancer

looks like a cotton ball spotted with paint

33
Q

Lymphoma

A

Cancer goes from lymph to the blood to the heart

TERRIBLE prognosis :(

34
Q

Mesothelioma cardiac

A

Dual identity tumor

Invasive in the pericardium
MC primary malignant pericardial tumor
Involve most of the parietal and visceral surfaces encasing the heart, with only superficial invasion of adjacent myocardium
Begin in the AV node
May result in heart block

35
Q

demographic of mesothelioma

A

MC in adults, 2:1 male predominance
not d/t asbestos
pericarditis, tamponade, or constriction
often treat thinking it is something else, and then it does not respond to treatment
responses to radiation and chemotherapy are poor; surgical pericardiectomy offers a palliative measure

36
Q

MC Secondary metastatic cardiac tumor

A

Melanoma (MC)

close second is renal cell carcinoma

37
Q

involvement of secondary/metastatic cardiac tumor

A

Myocardial > coronary > intracavitary involvement occur uncommonly

38
Q

symptoms of right atrial block

A

Edema, right sided HF

39
Q

Intracardiac thrombus is caused by

A

Stasis of blood from an appendage

40
Q

What side of the heart is affected with intracardiac thrombus

A

left side

left atrium
left ventricle – particularly the apex

41
Q

What can result from intracardiac thrombus? What is the diagnostic modality of choice for an intracardiac thrombus?

A

May result in embolic events, such as CVA/TIA, mesenteric ischemia, acute limb ischemia
Otherwise asymptomatic
Diagnosis is made by echocardiogram

42
Q

Left atrial thrombosis causes

A

A. fib (#1)
Left atrial appendage
Mitral stenosis

43
Q

Left ventricular thrombus causes

A

Causes?
Dilated cardiomyopathy (#1)
MI resulting in decreased apical wall motion
Stress cardiomyopathy

Most LV thrombi are more stable than LA thrombi after about 30 days because they wall themselves off

44
Q

treatment of intracardiac thrombus

A

Prophyaxis in A fib with anticoagulants

Warfarin if you have an issue (2.0-3.0) for at least 3 months

45
Q

If someone has a CI of anticoagulation

A

Major bleeding
Mass in brain

Can use a thromboectomy

Cardiology (22 decks)

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