History
Any patient with an embolic complication or signs or symptoms of inflow or outflow obstruction (ie, left or right heart failure) should have an evaluation with cardiac tumor considered in the differential diagnosis.
Heart failure
Chamber obliteration by tumor involvement or abnormal myocardial function and arrhythmias is secondary to intramyocardial tumor growth.
Tumor growth can cause signs and symptoms of left ventricular outflow tract obstruction.
Diastolic murmurs might indicate impaired valve function due to tumor compression or growth.
Palpitations
Tumor involvement of the conduction system might cause palpitations or syncopal episodes.
Sudden death
Sudden death has been reported in as many as 33% of cases.
Syncope
Syncopal episodes might be related to associated arrhythmias.
Physical Examination
Cardiac findings
The following signs may be found on cardiac evaluation:
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Systolic or diastolic murmur changing with different positions
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Delayed, split, or altered S1
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Tumor "pop"
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Congestive heart failure
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Jugular venous distension
Neurologic findings
Focal deficits range from transient ischemic attacks to hemispheric stroke from cerebral embolism.
Embolic complications are extremely rare with fibromas but more common with myxomas.
Pulmonary findings
Patients with impaired left ventricular filling or function might exhibit signs of congestive heart failure.
Signs include rales, shortness of breath, and cough.
Abdominal findings
Right atrial or ventricular involvement can impair venous return and cause hepatosplenomegaly or ascites.
Extremity examination findings
Heart failure can cause peripheral edema.
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Benign Cardiac Tumors. Resected left atrial myxoma.
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Benign Cardiac Tumors. Resected cardiac fibrosarcoma.
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Benign Cardiac Tumors. Large epicardial cardiac lipoma.
