Benign Cardiac Tumors Clinical Presentation

Updated: Aug 05, 2016
  • Author: Dale K Mueller, MD; Chief Editor: Karlheinz Peter, MD, PhD  more...
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Presentation

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

This has been reported in as many as 33% of cases.

Syncope

Syncopal episodes might be related to associated arrhythmias.

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Physical Examination

Cardiac findings

The following signs may be found on cardiac evaluation:

  • Systolic or diastolic murmur changing with different positions
  • Delayed, split, or altered S 1
  • Tumor "pop"
  • Congestive heart failure
  • 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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