Cardiac tumors: echo assessment

Rekha Mankad, Joerg Herrmann

Cardiac tumors are exceedingly rare (0.001-0.03% in most autopsy series). They can present anywhere within the heart and can be attached to any surface or be embedded in the myocardium or pericardial space. Signs and symptoms are non-specific and highly variable, related to the localization, size, and composition of the cardiac mass. Echocardiography, typically ordered for another indication, may be the first imaging modality alerting the clinician to the presence of a cardiac mass. Although echocardiography cannot give histopathology, certain imaging features and adjunctive tools such as contrast imaging may aid in the differential diagnosis as do adjunctive clinical data and the following principles: 1) thrombus or vegetations are the most likely etiology, 2) cardiac tumors are mostly secondary, and 3) primary cardiac tumors are mostly benign. While the finding of a cardiac mass on echocardiography may generate confusion, a stepwise approach may serve well practically. Herein we will review such an approach and the role of therein: echocardiography for the assessment of cardiac masses.