The role of echocardiography in the assessment of cardiac masses – a retrospective study

Introduction: The management of cardiac tumors is very difficult due to their rarity. Echocardiography today is considered the front line for the diagnosis of cardiac tumors. It may direct us, with high accuracy, towards differentiating primary or secondary cardiac tumors or even benign from malignant. This study has followed in comparison the echocardiographic, intraoperative and anatomopathological aspects, in patients with intracardiac masses, and tried to prove a significantly statistic correlation between these three aspects. Methods: The paper is a retrospective cohort study on patients who were admitted in the Cardiovascular Disease Institute of Timișoara, on a period of five years (2006-2011). We enrolled 25 patients, all admitted in our clinic with the diagnosis of intracardiac mass. The evaluation included complete echocardiography exam that identified the intracardiac mass and its potential hemodynamic consequences. This was followed by the surgical removal of the mass and the macroscopic intraoperative description and finally a detailed anatomopathological exam. We compared echocardiographic, intraoperative and anatomopathological findings for each patient. Results: From all of the 25 intracardiac masses, 20 were in the left atrium, 2 were in the right atrium, two in the ventricular cavities and one at the level of the aortic valve. From the total of intracardiac masses, 22 had the macroscopic and anatomopathological aspect of myxoma, the others being a fibroelastoma and two thrombotic masses, data that confirmed the suspicionĀ risen in the echocardiographic examination. Twenty of the 22 myxomas were localized in the left atrium. The two thrombotic masses were found in the atrial cavities. From the entire sample of patients, 3 patients presented ischemic strokes in their patient history and 3 patients were in atrial fibrillation at the moment of examination. Conclusions: The myxoma represents over half of the benign cardiac tumors of the adult with maximum incidence in the 5th decade of life. There is an affinity for the left atrium and the myxomas are more frequent in females, data that resemble the data found in the literature. The most frequent complications of intracardiac masses were stroke and atrial fibrillation. The present study underlines the importance of echocardiography as an elective imagistic method in the evaluation of intracardiac masses and shows a strong correlation between echocardiographic examination, the macroscopic aspect post-surgical excision and the anatomopathological exam.

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