Cardiac
Sarcoma
Cardiac
sarcoma is a type of tumor that occurs in the
heart. Cardiac sarcoma is a primary malignant
(cancerous) tumor. Tumors are considered to be
either primary tumors or secondary tumors. A primary
tumor is the original site of tumor growth. A
secondary tumor originates from another tumor
elsewhere in the body. Primary tumors of the heart
are rare, and over 75 percent of primary cardiac
tumors are benign (non-cancerous).
The
symptoms of heart tumors will vary, depending
on the location of the tumor. Tumors of the heart
may occur on the outside surface of the heart,
within one or more chambers of the heart (intracavitary),
or within the muscle tissue of the heart.
Cardiac
sarcomas, most frequently, are a type of sarcoma
called angiosarcoma. Angiosarcomas usually begin
in the right atrium (right upper chamber) of the
heart, or on the pericardium (outer surface) of
the heart. Approximately 80 percent of angiosarcomas
occur in the right atrium resulting in obstruction
of the inflow or outflow of blood. This obstruction
may cause symptoms such as swelling of the feet,
legs, ankles, and/or abdomen, and distension of
the neck veins, because the blood coming back
to the heart after traveling through the body
cannot easily enter or be pumped out of the right
atrium.
Cardiac
angiosarcomas that occur on the pericardium can
cause increased fluid in the pericardial sac,
the thin covering that surrounds the heart. If
enough fluid accumulates within the pericardial
sac, the heart's ability to pump blood is
affected. Some signs of this occurrence may include
chest pain, shortness of breath, fatigue, and
palpitations.
Tiny
pieces (emboli) of cardiac sarcomas may break
off and travel through the bloodstream to other
parts of the body. An embolus may block blood
flow to an organ or body part, causing pain and
damage to the organ or body part that lies beyond
the point at which the blood flow is obstructed.
Emboli can affect the brain (causing a stroke),
the lungs (causing respiratory distress), and/or
other organs and body parts.
Additional
symptoms include hemoptysis (coughing up blood),
heart rhythm problems and upper facial congestion.
Other signs of cardiac sarcoma not related to
the location of the tumor in the heart may include
fever, weight loss, night sweats, and malaise
(fatigue, tiredness, or "not feeling well").
The
symptoms of cardiac sarcoma may resemble other
cardiac or medical conditions. Always consult
your physician for a diagnosis.
The
methods for diagnosing cardiac sarcoma vary, to
some degree, based on the symptoms present. In
addition to a complete medical history and physical
examination, diagnostic procedures for cardiac
sarcoma may include the following:
- echocardiogram (also
known as echo) - a noninvasive test that uses
sound waves to produce a study of the motion
of the heart's chambers and valves. The
echo sound waves create an image on the monitor
as an ultrasound transducer is passed over the
heart. Echocardiography has become the most
useful tool in the diagnosis of cardiac sarcoma,
allowing the physician to see the exact size
and location of the tumor.
- electrocardiogram
(ECG or EKG) - a test that records the electrical
activity of the heart, shows abnormal rhythms
(arrhythmias or dysrhythmias), and detects heart
muscle damage; cardiac sarcoma may cause changes
in the heart's rhythm, however, these EKG
changes may indicate other heart problems, so
other diagnostic tools are needed to make a
definitive diagnosis of cardiac sarcoma or any
other type of heart tumor.
- computed tomography
(Also called a CT or CAT scan.) - a diagnostic
imaging procedure that uses a combination of
x-rays and computer technology to produce cross-sectional
images (often called slices), both horizontally
and vertically, of the body. A CT scan shows
detailed images of any part of the body, including
the bones, muscles, fat, and organs. CT scans
are more detailed than general x-rays and are
used to further define the tumor's size,
location, and other characteristics.
- magnetic resonance
imaging (MRI) - a diagnostic procedure that
uses a combination of large magnets, radiofrequencies,
and a computer to produce detailed images of
organs and structures within the body; to further
define the tumor's size, location, and other
characteristics.
- chest x-ray - a diagnostic
test which uses invisible electromagnetic energy
beams to produce images of internal tissues,
bones, and organs onto film; may detect heart
enlargement or pulmonary congestion.
- cardiac catheterization
- with this procedure, x-rays are taken after
a contrast agent is injected into an artery
- to locate the narrowing, occlusions, and other
abnormalities of specific arteries.
Specific
treatment for cardiac sarcoma will be determined
by the physician based on:
- your age, overall health,
and medical history
- extent of the disease
- your tolerance for
specific medications, procedures, or therapies
- expectations for the
course of the disease
- your opinion or preference
Once
a cardiac sarcoma has progressed to the point
that symptoms begin to occur, it has often spread
to other parts of the body (in 80 percent of cases),
making treatment difficult and challenging. This
spread to other parts of the body is called metastasis.
The type of treatment for cardiac sarcoma depends
largely upon the location and size of the tumor,
as well as the extent of metastasis.
The
physician may determine that the tumor can be
removed, which is done with an open-heart surgical
procedure. This is often difficult, however, because
of the location of the tumor.
In some
cases, the sarcoma has invaded the heart to such
an extent that it is impossible to remove it completely.
In this situation, heart transplantation has been
attempted. However, a patient must receive immunosuppressive
medication (medications which help to prevent
the body from rejecting foreign tissue) after
transplant, and this medication may stimulate
new growth of sarcoma.
An exciting
new prospect for treatment of cardiac sarcoma
is autotransplantation. Autotransplantation is
a surgical procedure in which the patient's
own heart is removed so that the tumor can be
more completely and easily removed from the heart
tissue. After the tumor is removed, the heart
is replaced into the patient. Because the patient
has not received a heart from another person,
there is no need for immunosuppressive medications.
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