Hypertrophic Cardiomyopathy with a Twist

Hypertrophic cardiomyopathy is a relatively common inherited cardiac disorder, with echocardiography still being the initial imaging method for its diagnosis. Cardiac fibroma is a primary neoplasm that most commonly presents in childhood. We present a patient who was investigated for typical cardiac symptoms who went on to have cardiac magnetic resonance imaging and was found to have both of these conditions.

Aortic coarctation with cardiac fibroma in a young patient: a case report

Background Cardiac fibroma and aortic coarctation are rarely observed concomitantly in the same patient. We report a case of cardiac fibroma with aortic coarctation treated with a hybrid surgical procedure. To the best of our knowledge, this is the first case of these two abnormalities existing in one patient. Case summary A 22-year-old female patient visited the clinic with a 10-year history of hypertension. Physical examination revealed blood pressure of the upper extremities 50 mmHg higher than that of the lower extremities. Computed tomography angiography revealed a post-ductal-type aortic coarctation at the beginning segment of the descending aorta along with a 7.7 cm × 5.1 cm left ventricular mass. Transthoracic echocardiogram showed a mass at the middle segments of the lateral wall and apex and posterior wall of the left ventricle. Cardiac magnetic resonance imaging also showed the mass with hypointense signal on T1, hyperintense signal on T2, and intense signal on late gadolinium enhancement. No evidences of metastatic lesions were observed on 18F-fluorodeoxyglucose positron emission tomography. The patient underwent a hybrid surgery involving aortic stent implantation and complete left ventricular mass removal. The gradient between stenosis returned to <10 mmHg after the procedure. Pathologic findings revealed cardiac fibroma. Discussion It is rare to encounter a patient suffering from both cardiac fibroma and aortic coarctation. No evidences indicated a single cause or syndrome resulting in the coexistence of these two abnormalities. A hybrid surgery involving aortic stent implantation and complete cardiac mass resection could optimize the treatment in such cases.

Don’t Forget the Cardiac Fibroma: Coronavirus Disease 2019 and the Management of Patient with a Large Cardiac Fibroma

COVID-19 has introduced a monumental challenge to the routine delivery of healthcare and protection of healthcare professionals. Conditions that are life threatening and need urgent intervention add another layer of complexity. This brief report reviews the management of a large cardiac fibroma found in the setting of COVID-19.

Cardiac fibroma with cardiac arrest: a rare clinical presentation of Gorlin syndrome in an 8-month-old infant

Paediatric cardiac tumours are rare, often benign and carry associations with genetic conditions. Cardiac fibromas are mainly composed of fibroblast and connective tissue . They can lead to symptoms due to obstruction of blood flow or arrythmias. In this case, we report an 8-month-old girl child who presented to paediatric cardiology office for cardiac evaluation given a family history of Gorlin syndrome, also known as nevoid basal cell carcinoma syndrome, found to have a large 4×4×6 cm fibroma in the apical lateral free wall of the left ventricle and later presented to the emergency department with cardiac arrest.

Giant Right Ventricular Fibroma: Prenatal Diagnosis and Partial Resection in Early Infancy

Congenital cardiac fibromas are very rare and prenatal diagnosis has been reported in just a few cases. We describe a four-month-old infant presenting a symptomatic giant right ventricular fibroma discovered during prenatal scanning at 33 weeks of gestation, which was confirmed after delivery on echocardiogram and cardiac magnetic resonance imaging. Due to progressive hemodynamic deterioration, partial surgical resection was performed and the patient recovered uneventfully. We report the successful management during early infancy of a giant cardiac fibroma prenatally diagnosed.

Case report: surgical resection of right ventricular cardiac fibroma in an adult patient

Background Cardiac fibromas are rare benign cardiac neoplasms, most frequently occurring in the pediatric population; with very rare cases identified in adults. The tumors are comprised of spindled cells with myofibroblastic ultrastructural features embedded in generally collagenous and elastic stroma. The tumors are intramural in the ventricles, most commonly the left ventricle. Clinical symptoms vary by location and size of tumor and some are asymptomatic. Surgical resection is curative, but rare cases require cardiac transplantation. Case presentation We report an asymptomatic, large, right ventricular fibroma in a 64-year-old woman. The patient underwent open incisional tumor biopsy via lower hemi-sternotomy, followed by complete tumor resection via full sternotomy a week later after confirming the tumor is benign. The tumor was resected using cardiopulmonary bypass, and the defect of right ventricular free wall was repaired using a prosthetic double-patch technique. The postoperative course was uneventful. The patient was discharged to home on day 4 post-complete tumor resection. Conclusion This report expands the existing literature for better comprehension and detection of cardiac fibroma patients and also highlights the various imaging modalities, surgical management, and histological analysis.

Fibroma of the interventricular septum with bilateral obstruction of the ventricular outflow/tracts

Heart fibroma accounts for about 5% of all primary neoplasms and is registered in children in 80% of cases. The ventricles or interventricular septum (IVS) are most often affected; in half of cases, the tumor has intracavitary growth. The clinical picture of the disease and its prognosis depend on the size and location of the tumor. The most unfavorable is the defeat of the IVS, since it causes obstruction of the output tract of one of the ventricles. Being localized in IVS, can involve a conducting system of heart, thereby increasing risk of sudden death.A retrospective study of a case of cardiac fibroma in a child aged 4.5 months, confirmed by echocardiography, magnetic resonance imaging and successfully operated on in the Central Federal District Center of Penza, is presented. A large tumor, localized in the IVS, caused atypical obstruction of the outflow tracts of both ventricles simultaneously. In the domestic and foreign literature, hemodynamic disturbances of only one of the ventricles are described, and we did not find a single case with simultaneous obstruction of both tracts. The possibility of MRI in the diagnosis of heart tumors has been shown.