Clinical presentations, diagnosis, and management of arrhythmias associated with cardiac tumors

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Abstract

Cardiac tumors are a rare cause of arrhythmias in clinical practice. They can cause a broad spectrum of arrhythmias, from low‐grade ectopics to incessant ventricular tachycardias, including sudden cardiac arrest. Both primary and secondary cardiac tumors can produce arrhythmias, but not all tumors cause arrhythmias. Although cardiac tumors can cause arrhythmias in fetuses and older adults alike, only specific cardiac tumors are the underlying cause of arrhythmia in different age groups. This article reviews various cardiac tumors that are associated with arrhythmias, their clinical presentations, diagnostic features, and management.

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Most cited references 29

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Cardiac myxomas.

K Reynen (1995)

Although cardiac myxomas are histologically benign, they may be lethal because of their strategic position. They can mimic not only every cardiac disease but also infective, immunologic, and malignant processes. Myxomas must therefore be included in the differential diagnosis of valvular heart disease, cardiac insufficiency, cardiomegaly, bacterial endocarditis, disturbances of ventricular and supraventricular rhythm, syncope, and systemic or pulmonary embolism. The symptoms depend on the size, mobility, and location of the tumor. Echocardiography, including the transesophageal approach, is the most important means of diagnosis; CT and MRI may also be helpful. Coronary arteriography in patients over 40 years of age is generally required to rule out concomitant coronary artery disease. Surgical removal of the tumor should be performed as soon as possible; the long-term prognosis is excellent, and recurrences are rare. In follow-up examinations as well, echocardiography is essential.

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Cardiac tumours: diagnosis and management.

Jagdish Butany, Vidhya Nair, Ather Naseemuddin … (2005)

Primary cardiac tumours are rare, with an autopsy incidence ranging from 0.001% to 0.030%. Three-quarters of these tumours are benign and nearly half of the benign tumours are myxomas. Metastases to the heart are far more common than primary cardiac tumours. Primary cardiac tumours present with one or more of the symptoms of the classic triad of: cardiac symptoms and signs resulting from intracardiac obstruction; signs of systemic embolisation; and systemic or constitutional symptoms. They are diagnosed by use of transthoracic and transoesophageal echocardiograms, MRI, and CT scan. Whereas surgery is indicated in patients with benign tumours, systemic chemotherapy is indicated in those who have widespread or unresectable malignant disease, and chemotherapy and radiotherapy are usually combined in treatment of patients with primary cardiac lymphomas. The prognosis after surgery is usually excellent in the case of benign tumours but is unfortunately still limited in localised malignant diseases. Patients with sarcomas live for a mean of 3 months to 1 year, and those with lymphomas live up to 5 years if treated, but usually die within 1 month if untreated.

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Primary cardiac tumors: early and late results of surgical treatment in 91 patients.

Paolo Centofanti, Elio Di Rosa, Luca Deorsola … (1999)

Between March 1980 and September 1997, 91 patients underwent evaluation and treatment for primary cardiac neoplasms. Tumors were grouped into three categories: atrial myxomas, benign nonmyxomas, and malignant tumors. Survivors were contacted; no one was lost to follow-up. The mean follow-up for this series is 7 +/- 5 years. Eighty-three patients were diagnosed with atrial myxomas (Male/Female: 29/54), average age 55 +/- 13 years. The hospital mortality was 3.6% (3/83), the late mortality was 6.5% (5/80). No recurrent myxomas have been identified clinically or by echocardiography in any patient. Three patients were diagnosed with benign nonmyxoma tumors. (Male/Female: 2/1), average age 64 +/- 8 years. There were no perioperative deaths and 1 patient died 4 years postoperatively from fibroma, with no linked causes. No recurrent tumors have been identified. Five patients were diagnosed with malignant tumors. (M/F: 1/4), average age 53 +/- 16 years. The hospital mortality was 20% (1/5); in 3 patients a redo-operation was necessary after 8, 11, and 12 months because of tumor recurrence. All patients died within 3 years of the first operation (mean 13 +/- 14 months). Surgical resection, when possible, is the treatment of choice for all primary cardiac tumors. Patients with benign tumors are probably cured by resection and in our experience there was no known tumor recurrence. Effective palliation is possible with resection of malignant tumors, but more effective adjuvant therapy will be necessary to improve long-term prognosis.

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Author and article information

Contributors

Shenthar Jayaprakash: jshenthar@yahoo.com

Journal

Journal ID (nlm-ta): J Arrhythm

Journal ID (iso-abbrev): J Arrhythm

Journal ID (doi): 10.1002/(ISSN)1883-2148

Journal ID (publisher-id): JOA3

Title: Journal of Arrhythmia

Publisher: John Wiley and Sons Inc. (Hoboken )

ISSN (Print): 1880-4276

ISSN (Electronic): 1883-2148

Publication date (Electronic): 07 March 2018

Publication date Collection: August 2018

Volume: 34

Issue: 4 ( doiID: 10.1002/joa3.2018.34.issue-4 )

Pages: 384-393

Affiliations

[ ¹ ] Electrophysiology Unit Department of Cardiology Sri Jayadeva Institute of Cardiovascular Sciences and Research Bangalore India

Author notes

[*] [* ] Correspondence

Prof. Jayaprakash Shenthar, Electrophysiology Unit, Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India.

Email: jshenthar@ 123456yahoo.com

Article

Publisher ID: JOA312030

DOI: 10.1002/joa3.12030

PMC ID: 6111472

PubMed ID: 30167009

SO-VID: e242e69c-cb85-4cf5-8b86-d8973d0d717d

License:

This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

History

Date received : 15 July 2017

Date accepted : 23 August 2017

Page count

Figures: 3, Tables: 4, Pages: 10, Words: 6151

Custom metadata

source-schema-version-number 2.0

component-id joa312030

cover-date August 2018

details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.4.4 mode:remove_FC converted:28.08.2018

Keywords: arrhythmias,cardiac tumors,incessant tachycardias,pediatric arrhythmias,sudden death

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Keywords: arrhythmias, cardiac tumors, incessant tachycardias, pediatric arrhythmias, sudden death

Clinical presentations, diagnosis, and management of arrhythmias associated with cardiac tumors

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Most cited references 29

Cardiac myxomas.

Cardiac tumours: diagnosis and management.

Primary cardiac tumors: early and late results of surgical treatment in 91 patients.

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