What are the signs and symptoms of cardiac sarcoma?

Updated: Jan 17, 2019
  • Author: John H Raaf, MD, PhD; Chief Editor: Eric H Yang, MD  more...
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Answer

The diagnosis of cardiac sarcoma is often not made preoperatively or even antemortem. It is overlooked because of the rarity of the lesion and the nonspecific nature of the symptoms and signs. Tumors that originate in the epicardium or pericardium and that lead to cardiac encasement may cause chest pain, hypotension, tachycardia, and malaise. Diminished cardiac sounds and a friction rub may be heard.

Cardiac tamponade (usually from a persistent and bloody pericardial effusion) may eventually cause intractable cardiac failure. Myocardial involvement may lead to refractory arrhythmias, heart block, heart failure, angina, or infarction. Endomyocardial masses cause valvular obstruction or insufficiency. Rarely, a pedunculated tumor causes an audible plop from tumor prolapse through a valve. Tumor fragments may embolize from the right side of the heart to the lungs and cause dyspnea or hemoptysis. Left-sided emboli may lead to cerebrovascular accidents, peripheral organ infarctions, seizures, and distant metastases. Local extension of tumors may cause signs and symptoms such as superior vena cava syndrome, hemoptysis, and dysphonia.


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