Definition & Overview
Tumors, or abnormal masses of tissue, can sprout at any time in any part of the body. The heart is no exception although the occurrence is pretty rare. Tumors in the heart are called cardiac tumors and though some of them may be insignificant, others may be life-threatening. Cardiac tumors are classified as either benign – those that are slow-growing and generally don’t cause any trouble – and malignant (cancerous) or those that are fast-growing and have the potential to spread to other parts of the body.
Cardiac tumors are also classified as either primary or secondary.
Primary cardiac tumors refer to those that originally grow in the heart and don’t get transferred anywhere else. This is a very rare type of cardiac tumor and affects about 1 in 1,000 to 1000,000 people. The majority of primary cardiac tumors are benign and the most common is called myxoma, which usually grows in the left upper chamber of the heart (the atrium). 25% of primary cardiac tumors end up being malignant; the most common is called sarcoma.
Secondary cardiac tumors refer to those that grew from a different part of the body and ended up moving to and eventually, getting attached to the heart. These are more common as they result from the metastasis of other tumors in the lungs, breasts, stomach, kidneys, liver or colon.
Thus, cardiac tumors can be:
Benign primary cardiac tumors – non-cancerous, originally grew in the heart
Malignant primary cardiac tumors – cancerous, originally grew in the heart
Malignant secondary cardiac tumors – cancerous, grew from another part of the body; also called metastatic cardiac tumors
Cause of Condition
There is no definitive cause of cardiac tumors, but it is mostly believed to be the result of the abnormal regulation of cell division. In some cases, heredity and genetics play a major role. Sometimes, other health conditions contribute to the growth like NAME, LAMB or Carney syndromes. Key Symptoms
The symptoms of cardiac tumors, which often resemble other heart diseases, are the following:
Extracardiac symptoms may be (1) constitutional (change in the patient’s behavior or external physical symptoms), such as fever, chills, lethargy and weight loss; or (2) mechanical (trouble in the function of some parts of the heart). The constitutional extracardiac symptoms are very similar to those of bacterial endocarditis and connective tissue disorders. An example of a mechanical extracardiac symptom may include tumors that fragment and breakaway into the bloodstream, causing clots or blockages.
Intramyocardial symptoms are caused by arrhythmias (abnormal heart rhythm) when the myocardium (the muscle tissue of the heart that contracts to push blood out) malfunctions. These include blockages, rapid heartbeats, enlargement of the heart and heart murmurs.
Intracavitary symptoms present when there’s an obstruction in valvular function, blood flow or both.
When this happens, the following symptoms can be observed:
- Difficulty breathing when lying flat or when sleeping
- Fainting, lightheadedness or dizziness
- Palpitations or rapid heart rate
- Chest pain or tightness in the chest
Symptoms of a malignant tumor, whether it’s primary or secondary, may present as sudden heart enlargement, bizarre changes in the shape of the heart (as seen on a chest x-ray), tamponade (compression of the heart due to the accumulation of fluid in the pericardial sac) and sudden heart failure.
Who to See and Types of Treatments Available
Diagnosing cardiac tumors can be challenging due to the similarity of its symptoms to a number of heart ailments. Also, cardiac tumors sometimes don’t present any symptom at all and are most likely discovered by accident when patients are being tested for another type of ailment. This is the reason why doctors perform various diagnostic tests to accurately identify the condition.
Aside from assessing the symptoms and reviewing the patient's medical history, the following diagnostic tests are also typically prescribed:
- Blood testing
- Chest x-ray
- (ECG), which checks the electrical activity of the heart
- Electrocardiogram (EKG), which diagnoses arrhythmia
- Imaging tests such as MRI, CT scan and coronary angiography
Through these tests, the doctor will determine the size of the mass, its potential mobility, and its location. This leads to a precise diagnosis, which is the basis for formulating definite treatment protocol.
Treatment options include:
Tumor excision through surgery – This is a preventive measure performed to remove primary cardiac tumors. This can be performed using minimally invasive techniques, which result in minimal bleeding, faster recovery time, and smaller incisions. With this treatment option, there is a high probability that the tumor will not return after surgery.
For malignant primary cardiac tumors, treatment is more palliative because surgery is no longer an option. Radiation and chemotherapy are recommended treatments but successful recovery is rare.
For metastatic cardiac tumors, treatment includes systemic chemotherapy or palliation. Like malignant primary cardiac tumors, successful recovery is practically nil.
Salcedo EE, Cohen GI, White RD, Davison MB. Cardiac tumors: diagnosis and management. Curr Probl Cardiol. 1992 Feb. 17(2):73-137
- Lund JT, Ehman RL, Julsrud PR, et al. Cardiac masses: assessment by MR imaging. AJR Am J Roentgenol. 1989 Mar. 152(3):469-73