scholarly journals Utility of cardiac imaging in diagnosis of atypical presentation of cardiac fibroma

2019 ◽  
Vol 12 (9) ◽  
pp. e230333
Author(s):  
Catalina Flores ◽  
Jaclyn Lundberg ◽  
Randy R Richardson ◽  
Deepa Prasad

Primary cardiac tumours are relatively rare in the paediatric population, with benign tumours accounting for >90% of cases. Cardiac fibromas are rare primary tumours that typically reside in the ventricles. Symptoms are usually the result of blood outflow obstruction or disruption of the cardiac conduction system. They do not typically regress and usually require surgical intervention. In this case, we report a rare finding of a right atrial fibroma in an 18-month-old female who presented with lethargy and vomiting. Chest X-ray revealed an enlarged cardiac silhouette, and follow-up CT showed a 3.7×3.2×3.7 cm hypodense lesion in the right atrium. Cardiac MRI revealed the diagnosis, which was confirmed on pathology.

1975 ◽  
Vol 228 (5) ◽  
pp. 1440-1445 ◽  
Author(s):  
WJ Mandel ◽  
MM Laks ◽  
AI Arieff ◽  
K Obayashi ◽  
H Hayakawa ◽  
...  

Simultaneous measurements of hemodynamics, arterioventricular (AV) conduction, and renal functioner were obtained in conscious dogs. Catheters were implanted for the long-term measurement of central aortic, right ventricular, and pulmonary artery pressure. AV conduction was assessed following surgical implantation of multipolar electrode plaques in the area of the bundle of His, as well as on the epicardium of the right and left atria and ventricles. Renal function was assessed utilizing standard techniques. Following control measurements, lidocaine, 1 mg/kg, or procaine amide, 10 mg/kg, was administered intravenously. Subsequently, serial measurements were obtained for a 90-min period. No significant changes in hemodynamics were observed following either drug. Procaine amide produced a significant increase in heart rate and a minimal increase in QRS duration associated with a decrease in low right atrial to His bundle conduction time. However, no significant changes in cardiac conduction were observed after lidocaine administration. Renal function was unaffected by lidocaine but significantly depressed by procaine amide, as demonstrated by a decrease in GFR and effective renal flow. In summary, acute administration of procaine amide significantly alters renal function in the conscious dog with minimal effects on AV conduction and hemodynamics.


2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Fahad Syed Naseerullah ◽  
Hemangkumar Javaiya ◽  
Avinash Murthy

Primary tumours of the heart are often encountered in clinical practice. Different autopsy series estimate the incidence to be anywhere from 0.001% to 0.19%. Cardiac lipoma is a rare type of tumour of the heart and pericardium. It comprises approximately 10–19% of all cardiac tumours. We present a case of a large cardiac lipoma in a fifty-year-old female. She presented with sharp chest pains, palpitations, and dizziness. Acute coronary syndrome was ruled out. A transthoracic echocardiogram showed an abnormal, large, fixed right atrial mass. The mass was noted to be occupying most of the right atrium. It was excised due to its large size and persistent symptoms. On pathophysiology, the mass was definitively diagnosed to be an 80 mm × 70 mm cardiac lipoma. Postoperatively, the patient did well with resolution of her symptoms. This case provides evidence that even large, invasive, symptomatic cardiac lipomas can be successfully resected with good outcomes.


2018 ◽  
Vol 75 (5) ◽  
pp. 512-515 ◽  
Author(s):  
Sasa Hinic ◽  
Jelena Saric ◽  
Predrag Milojevic ◽  
Jelena Gavrilovic ◽  
Tijana Durmic ◽  
...  

Introduction. Myxoma is the most common primary benign heart tumor. The most frequent location is the left atrium, the chamber of the heart that receives oxygen- rich blood from the lungs. Myxomas usually develop in women, typically between the ages of 40 and 60. Symptoms may occur at any time, but most often they are asymptomatic or oligosymptomatic for a long period of time. Symptoms usually go along with body position, and are related to compression of the heart cavities, embolization and the appearance of general symptoms. The diagnosis of benign tumors of the heart is based on anamnesis, clinical features and findings of the tumor masses by use of non-invasive and invasive imaging methods. Extensive surgical resection of the myxoma is curative with minimal mortality. Long term clinical and echocardiographic follow-up is mandatory. Case report. We reported a case of a 62-year-old male, presented with 15 days of intermittent shortness of breath, dizziness and feeling of heart palpitations and subsequently diagnosed with right atrial myxoma based on transthoracic echocardiography . The patient was emergently operated in our hospital. Long-term followup did not reveal recurrence. Conclusion. Our case was an atypical localisation of right atrial myxoma. Whether the intracardiac mass is benign or malignant, early surgery is obligatory in order to prevent complications.


2017 ◽  
Vol 56 (1) ◽  
pp. 9
Author(s):  
C. G. HATZIGIANNAKIS (Χ.Γ. ΧΑΤΖΗΓΙΑΝΝΑΚΗΣ) ◽  
M. E. MYLONAKIS (Μ. Ε. ΜΥΛΩΝΑΚΗΣ) ◽  
M. N. SARIDOMICHELAKIS (Μ.Ν. ΣΑΡΙΔΟΜΙΧΕΛΑΚΗΣ) ◽  
M. PATSIKAS (Μ. ΠΑΤΣΙΚΑΣ) ◽  
D. PSALLA (Δ. ΨΑΛΛΑ) ◽  
...  

A 7-year old female collie (case 1), a 3-year old male Caucasian-cross (case 2) and three male German shepherds with an age of 11 (case 3), 8.5 (case 4) and 10 (case 5) years, respectively, were admitted with a history of decreased appetite, depression, exercise intolerance, dyspnea and progressive abdominal enlargement, for the last 10 to 60 days. Poor body condition (5/5), muffled heart sounds (5/5), weak femoral pulse (5/5), ascites (5/5), inspiratory or inspiratory-expiratory dyspnea (5/5), pulsus paradoxus (2/5) and jugular vein distension (2/5) were the prominent clinical findings, while mature neutrophilic leukocytosis (3/5), lymphopenia (3/5), eosinopenia (3/5), hypoproteinemia (5/5) and increased urea nitrogen (3/5) were the most prevalent clinicopathologic abnormalities. Apart from a space-occupying lesion onto the right atrial wall of one dog (case 4), radiographic and ultrasound examination showed a globe-shaped cardiac silhouette (5/5), pericardial effusion (5/5), ascites (5/5) and pleural effusion (4/5). A large amount of non-clotting hemorrhagic effusion was drained during pericardiocentesis, resulting in rapid clinical recovery. Physical, chemical and cytological evaluation of the pericardial fluid was non-contributory in the differentiation between neoplastic and non-neoplastic causes of these effusions. Case 3 died 25 days post-pericardiocentesis; right atrium hemangiosarcoma and pulmonary metastases were documented on post mortem histopathological examination. Another dog (case 5) died of unknown causes one month after pericardiocentensis. On the contrary, dogs 1, 2 and 4 were still clinically healthy for a followup period of 16, 2 and 8 months, respectively.


2020 ◽  
Vol 2020 ◽  
pp. 1-14
Author(s):  
Qingbo Su ◽  
Xiquan Zhang ◽  
Hui Zhang ◽  
Yan Liu ◽  
Zhaoru Dong ◽  
...  

Purpose. This study aimed to retrospectively review the diagnosis and surgical treatment of uterine intravenous leiomyomatosis (IVL). Methods. The clinical data of 14 patients with uterine IVL admitted to our hospital between 2013 and 2018 were retrospectively analyzed, including their demographics, imaging results, surgical procedures, perioperative complications, and follow-up results. Results. The tumors were confined to the pelvic cavity in 7 patients, 1 into the inferior vena cava, 4 into the right atrium, and 2 into the pulmonary artery (including 1 into the superior vena cava). Only one case was misdiagnosed as right atrial myxoma before the operation, which was found during the surgery and was treated by staging surgery; all the other patients underwent one-stage surgical resection. Three patients underwent complete resection of the right atrial tumor through the abdominal incision, and one patient died of heart failure in the process of resection of heart tumor without abdominal surgery. During the 6–60 months of follow-up, 4 patients developed deep venous thrombosis of the lower extremity, and 1 patient developed ovarian vein thrombosis and pulmonary embolism. After anticoagulation treatment, the symptoms disappeared. One patient refused hysterectomy and the uterine fibroids recurred 4 years after the operation. Conclusion. Specific surgical plans for uterine IVL can be formulated according to cardiac ultrasound and computed tomography (CT). For the first type of tumor involving the right atrium, the right atrium tumor can be completely removed through the abdominal incision alone to avoid thoracotomy. The disease is at high risk of thrombosis and perioperative routine anticoagulation is required.


2007 ◽  
Vol 15 (4) ◽  
pp. 278-279 ◽  
Author(s):  
Vakeli Murat ◽  
Zhongxi Qian ◽  
Shuiyuan Guo ◽  
Jun Qiao

Between 1978 and 2002, 15 patients (mean age, 23.0 ± 8.5 years) with cardiac and pericardial echinococcosis were treated surgically. The cysts were located in the right atrium in 3 patients, on the anterior myocardium in 7, and pericardially in 5. The 3 patients with right atrial cysts were operated on using cardiopulmonary bypass. There were 4 recurrences requiring re-operation after a mean of 12 months. All other patients received mebendazole treatment and exhibited no recurrence during follow-up. One late death due to chronic right heart failure occurred after 10 months of follow-up. The serologic test is an effective method of diagnosis in undeveloped and developing countries.


1997 ◽  
Vol 5 (1) ◽  
pp. 20-24
Author(s):  
Fumikazu Nomura ◽  
Seiichiro Ikawa ◽  
Keishi Kadoba ◽  
Masataka Mitsuno ◽  
Yoshiki Sawa ◽  
...  

During a median follow-up period of 9 years (ranging from 9 months to 25 years), 24-hour ambulatory electrocardiographic studies were undertaken in 155 patients after repair of tetralogy of Fallot. The patients were divided into two groups. Group A consisted of 76 patients in whom the right ventricular approach was used and group B comprised 79 patients whose repair was through the right atrium. A transannular patch was employed in all patients in group A and in none of the patients in group B. Age at surgery was between 1 and 37 years (median age 4.8 years). During follow-up, 37 patients (48.6%) in group A had significant ventricular arrhythmias (Lown grade 2 or higher) and 13 patients (15.4%) in group B had significant ventricular arrhythmias. A close relationship was observed between age at surgery and Lown grade (R2 = 0.374, p < 0.001) and between follow-up duration and Lown grade (R2 = 0.514, p < 0.001), especially when the two groups were analyzed separately (R2 = 0.502, 0.476, p < 0.001). In contrast, no significant relationship was observed between the ratio of right ventricular to left ventricular pressure and Lown grade or between right ventricular systolic pressure and Lown grade. Discriminant analysis revealed risk factors associated with postoperative ventricular arrhythmias are follow-up duration (partial F = 3.22, p < 0.01), right ventricular to pulmonary artery pressure gradient (partial F = 3.35, p < 0.01), and operative method (partial F = 2.4, p < 0.05). Despite antiarrhythmic therapy, 11 of 22 late postoperative deaths occurred suddenly, presumably from ventricular arrhythmias. In this series of patients, the right atrial and pulmonary artery approach significantly reduced the risk of life-threatening ventricular arrhythmias after repair of tetralogy of Fallot.


2015 ◽  
Vol 5 (4) ◽  
pp. 26-33
Author(s):  
Joanna Płużańska ◽  
Kinga Jaguszewska ◽  
Jolanta Binikowska ◽  
Adam Oleś ◽  
Maciej Łukaszewski ◽  
...  

Abstract We present an extraordinary case of congenital enlargement of the right atrium diagnosed at 31 weeks of gestation. This case emphasizes the fact that timing of the detection of this particular cardiac malformation is of capital importance to tract the optimal treatment strategy in order to monitor further progression (in this case accompanying thrombosis) and prevent complications.


2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
João Pedro E. Sant’Ana ◽  
Amanda O. Vicente ◽  
Amanda S. Pereira ◽  
Pedro V. Bertozzi ◽  
Rodrigo A. S. Sardenberg

Primary idiopathic chylopericardium (PIC) is an uncommon cardiologic disorder; it is defined as accumulation of lymph in the pericardial sac without any know precipitating factor. A 25-year-old presented with dyspnea and chest pain for over two months. The patient underwent a chest X-ray, which revealed an enlargement of cardiac silhouette and signs of cardiac tamponade. Chest CT was performed, revealing large pericardial effusion and small pleural effusion on the right hemithorax. The patient was referred to the ICU and underwent a pericardial window through VATS, which revealed 500 ml of a milky fluid.


2007 ◽  
Vol 135 (7-8) ◽  
pp. 401-406
Author(s):  
Aleksandar Mikic ◽  
Biljana Obrenovic-Kircanski ◽  
Mladen Kocica ◽  
Mile Vranes ◽  
Vesna Lackovic ◽  
...  

Introduction Cardiac myxomas are the most frequent primary tumors of the heart in adults, and they can be found in each of four cardiac chambers. Although biologically benign, due to their unfavorable localization, myxomas are considered "functionally malignant" tumors. Diagnosis of cardiac myxoma necessitates surgical treatment. Objective To analyze: 1) the influence of localization, size and consistency of cardiac myxomas on preoperative symptomatology; 2) the influence of different surgical techniques (left, right, biatrial approach, tumor basis solving) on early, and late outcomes. Method From 1982 to 2000, at the Institute for Cardiovascular Diseases, Clinical Center of Serbia, there were 46 patients with cardiac myxomas operated on, 67.4% of them women, mean age 47.1?16.3 years. The diagnosis was made according to clinical presentation, electrocardiographic and echocardiographic examinations and cardiac catheterization. Follow-up period was 4-18 (mean 7.8) years. Results In 41 (89.1%) patients, myxoma was localized in the left, while in 5 (10.9%), it was found in the right atrium. Average size was 5.8?3.8 cm (range: 1?1 cm to 9?8 cm) and 6?4 cm (range: 3?2 cm to 9?5 cm) for the left and right atrial myxomas, respectively. A racemous form predominated in the left (82.6%) and globous in the right (80%) atrium. Fatigue was the most common general (84.8%) and dyspnoea the most common cardiologic symptom (73.9%). Preoperative embolic events were present in 8 patients (4 pulmonary, 4 systemic). In our series: 1) different localization, size and consistency had no influence on the preoperative symptomatology; 2) surgical treatment applied, regardless of different approaches and basis solving, resulted in excellent functional improvements (63.1% patients in NYHA III and IV class preoperatively vs. 6.7% patients postoperatively) and had no influence on new postoperative rhythm disturbances (8.7% patients preoperatively vs. 24.4% patients postoperatively); 3) early (97.8%), and late survival rates (91.3%) were excellent; 4) there were no relapses during the follow-up period. Conclusion Localization, size and consistency had no influence on the preoperative symptomatology. Excellent survival rate with significant functional improvement, rare postoperative complications and no recurrences, justify the applied strategies of surgical approach and tumor basis solving in our series.


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