History and physical examination of different cardiac masses

Key points

• Primary cardiac tumors (PCTs) are extremely rare that may be symptomatic or found incidentally.

• The signs and symptoms of cardiac tumors generally are determined by the location of the tumor in the heart and not by its histopathology.

• Cardiac myxoma is the most common benign heart tumor.

• The tumor plop sound is one of the classic and characteristic auscultation findings of cardiac myxoma. The other physical examination findings in cardiac tumors include prominent A wave with elevation of JVP; loud S1, S3, S4; and diastolic rumble.

• Malignant tumors are extremely rare and represent only 5% to 6% of PCTs. The most common are sarcomas.

• Cardiac metastases are 20–40 times more common than PCTs.

• Melanomas have the greatest propensity for cardiac involvement, and also carcinomas of the thorax, including breast, lung, and esophageal, are the most common carcinomas that metastasize to the heart.

Primary cardiac tumors (PCTs) are very rare . As an example, in one series of over 12,000 autopsies, only seven were identified with an incidence of less than 0.1% . Cardiac tumors may be symptomatic or found incidentally. In symptomatic patients, a mass can virtually always be detected by echocardiography, magnetic resonance imaging, and/or computed tomography. Because symptoms may mimic other cardiac conditions, the clinical challenge is to consider the possibility of a cardiac tumor so that the appropriate diagnostic test(s) can be conducted.

Clinical manifestations

The signs and symptoms of cardiac tumors generally are determined by the location of the tumor in the heart and not by its histopathology .