Cardiac Masses

Front 1

What are cardiac masses (6)

Back 1

Cardiac tumors, thrombus, vegetation, Iatrogenic material (pacemaker) Normal variants, extracardiac structures.

Front 2

Echo good to evaluate heart for masses

Back 2

where it is. how big masses are. HEMODYNAMIC EFFECT OF BLOOD FLOW through the heart

Front 3

Cardiac tumors

Back 3

Primary (rare)
Secondary (majority)

Front 4

which one is more common primary or secondary ?

Back 4

Secondary is more common for cardiac tumors

Front 5

Can you tell on echo if the tumor is benign or malignant

Back 5

NO
we can't definitely distinguish between benign and malignant tumor

Front 6

On echo we can assess the mass by

Back 6

the location, extent of mass, size of mass, where it originates.

Front 7

Secondary tumors are ALL malignant WHY?

Back 7

bc the metastasis from somewhere else. The can occur in 10% of all Fatal Malignancy

Front 8

Most common primary CA that metastasize (spreads) to the heart ?

Back 8

LUNGS
30% of cardiac secondary tumors are from the lungs

Front 9

Other common primary CA that metastasize to heart

Back 9

breast, kidney, liver, melanoma, AIDS related Lymphoma, Leukemia, Osteogenicsacroma

Front 10

There are certain tumors that metastasize to the IVC and as a result spread into the RA

Back 10

Hypernephroma, Hepatoma, Intravenous leiomyomatosis tumors *rare

Front 11

if you see a mass in the RA

Back 11

you need to evaluate the IVC

Front 12

What tumor tends to spread to the IVC (CA)

Back 12

WILMS TUMOR
anytime you see renal mass -look at IVC

Front 13

Primary tumors (RARE)

Back 13

benign
malignant

Front 14

do we treat benign primary tumors?

Back 14

yes bc they can be obstructive, break off and cause emboli

Front 15

Although most cardiac tumors are benign they can become a problem. Can cause

Back 15

systemic symptoms, embolic events, arrthyimas, Chest pain, Heart failure.

Front 16

Myxoma

Back 16

MOST common benign cardiac TUMOR.
Accounts for 20%-30% of all intracardiac tumors. Most commonly located: LA
3X more common in LA than on the RA

Front 17

What is unique about knowing if a mass is myxoma ( most common presentation)

Back 17

mass attached by a stalk to the middle of IAS - forman oval margin.

Front 18

What other views can you see IAS

Back 18

subcostal 4CH

Front 19

What percent of pts myxmoas are multiple?

Back 19

5%

Front 20

Population of patients myxoma

Back 20

young, family hx

Front 21

Embolic events are moer common in -----myxoma

Back 21

Smaller myxoma

Front 22

Myxoma is slow growing but untreated its ---

Back 22

FATAL , causes complete obstruction AV valves, NO CO if blood cant get out

Front 23

Ventricular Myxoma

Back 23

You will have LVOT obstruction

Front 24

Myxoma can cause obstruction

Back 24

prevent filling, CH won't get filled up, it can impair ventricular filling.

Front 25

Myxoma pt present with

Back 25

breathlessness, systemic emboli, fever, weakness,sudden death.

Front 26

Fibroma located in

Back 26

LV WALL, Ventricular septum, APex.

Front 27

Fibroma appearance

Back 27

See borders clearly, echogenic, multiple calcification.

Front 28

Does fibroma have hemodynamic consequence

Back 28

not really, unless it grows significantly in the LV cavity

Front 29

Fibroma worry about the possibilities of

Back 29

CONDUCTION ABNORMALITIES

Front 30

Rhabdomyomas (myocardial hamartoma)

Back 30

MOST COMMON cardiac TUmor in pediatric patients. Well circumscribed echogenic masses. Multiple mass present in the RV, RVOT, Pulmonary artery. NOT on the Left side.

Front 31

Unique about Rhabdomyomas

Back 31

commonly seen in patients with tuberous sclerosis. They can regress (shrink) when the baby is born) Spontaneously after birth

Front 32

Papillary Fibroelastoma Appearance

Back 32

Irregular shape, echogenic, mimic valvular vegetation

Front 33

Most frequently originates

Back 33

AO valve

Front 34

Fear complications for Papillary Fibroelastoma

Back 34

RISK OF emboli

Front 35

if on the AO valve it can look like an anatomic variant

Back 35

Lambls excresence

Front 36

Primary Malignant tumors

Back 36

Angiosacroma, Rhabdomyomasacroma, Fibrosacroma.

Front 37

Angiosacroma located in

Back 37

RA + Pericardial eff ] really bad

Front 38

Thrombus Most common cause in the heart ?

Back 38

Stasis of blood

Front 39

What kind of situations will cause stasis of blood

Back 39

Dilated CH, Obstruction and stagnation of blood flow, decrease Wall contractility (WMA)

Front 40

3 Scenarios where you will have stasis of blood

Back 40

Dilated CH, Decrease Contractility, Obstruction and stagnation of blood flow.

Front 41

What are some diseases that can produce these types of situation

Back 41

DOCM, POST MI, LA dilatation with severe MS, Prosthetic valves, Atrial fib- lack of atrial contraction

Front 42

The wall behind the thrombus is a pt with POST MI will be

Back 42

Diskinetic, Akinetic

Front 43

Why is thrombus happening

Back 43

Stasis of blood

Front 44

most common location from thrombus is apex of LV why?

Back 44

COMMON POST MI

Front 45

Why will the wall look like behind the thrombus

Back 45

dead, not moving, not thickening systole

Front 46

if you have a tumor the wall will be

Back 46

NORMAL

Front 47

if you have thrombus the wall

Back 47

won't be normal

Front 48

If you have a patient with LV thrombus, usually the patient as

Back 48

WA, Ventricular Aneurysm, LV Pseudo aneurysm (trauma) , DCMO

Front 49

LV thrombus to form there got to be some type of

Back 49

Dysfunction or WA

Front 50

Most common cause of LA appendage thrombus

Back 50

MS 2ndary to Rheumatic Heart disease

Front 51

Why do thrombus form at the right side of the heart

Back 51

Venous thrombi that emboli trapped on the tricuspid valve.

Front 52

Iatrogenic material ( doctor put it there)

Back 52

needles, ballons, pacemaker wire

Front 53

Lipomatous Hypertrophy of Atrial septum

Back 53

Dumbell sign, area of fossa ovals is spared.

Front 54

Extracardiac Structures

Back 54

Diaphragmatic hernia, pericardial cysts, Pseudoaneurysm, Large Hematoma, Mediastinal Tumor,CA aneurysm and or fistula.