Cardiac tumours: diagnosis and management

Until the 1950s, cardiac tumours were merely a curiosity. Diagnosis was academic and outlook poor. With the advent of cardiopulmonary bypass, however, surgical management became possible, particularly of intracavity tumours. More recently, the development of echocardiography, compututed tomography, and magnetic resonance imaging has contributed greatly to the process of preoperative diagnosis. Primary cardiac tumours are rare, with a necropsy incidence of 0.05%.1 Secondary deposits are seen more frequently, in 1% of postmortem examinations, but usually in the setting of widely disseminated malignancy.2 The relative incidence of presentation is shown in table 1, and demonstrates that atrial myxoma is by far the most common primary cardiac tumour in adults, and rhabdomyosarcoma is the most common in children. A quarter of all cardiac tumours are malignant, the majority of which are angiosarcomas or rhabdomyosarcomas. View this table: Table 1 Approximate incidence of benign tumours of the heart in adults and children ### General clinical features Cardiac tumours are diverse in clinical presentation, and atrial myxomas in particular may cause systemic symptoms mimicking collagen vascular disease, malignancy or infective endocarditis. There are several clinical features, however, that are seen commonly with many cardiac tumours: