Cardiac Sarcoma Workup

Updated: Oct 15, 2015
  • Author: John H Raaf, MD, PhD; Chief Editor: Eric H Yang, MD  more...
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Workup

Imaging Studies

Advances in diagnostic techniques have facilitated accurate, noninvasive assessment of cardiac sarcomas. [8]

Echocardiography is the preferred diagnostic procedure for noninvasive imaging of cardiac tumors (2-dimensional and transesophageal echocardiography are complementary). [9]

CT scanning is useful in detecting cardiac lesions, documenting local invasion of adjacent structures, and defining the presence of lung or liver metastases.

Angiography can help assess coronary artery luminal status and document intracardiac and intravascular tumors as filling defects.

Chest radiography may exhibit generalized cardiomegaly or right-sided heart enlargement, widened mediastinum, hilar adenopathy, pulmonary congestion, or pleural effusion.

MRI has the potential to define tumor histology, tumor location, and surrounding anatomy and to detect response to chemotherapy. [10, 11]

A study by Fussen et al found that comprehensive cardiovascular magnetic resonance examination is useful in risk stratification and clinical management in patients with suspected cardiac tumors. [12]

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Other Tests

ECG

More than 75% of patients with cardiac sarcomas have abnormalities that are generally nonspecific on ECGs.

Myocardial tumors can cause arrhythmias or various degrees of heart block.

Nonspecific ST and T wave changes may be observed.

Pericardial lesions may cause tachycardia and decreased voltage.

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Procedures

Pericardiocentesis allows cytologic examination and may relieve tamponade.

Endomyocardial biopsy provides tissue to use in diagnosis; however, this biopsy is not absolutely necessary preoperatively because tissue is obtained during surgical exploration.

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Histologic Findings

Specific subtypes of cardiac sarcomas have characteristic gross and microscopic features (see Pathophysiology).

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