Primary Cardiac Angiosarcoma with Spontaneous Ruptures of the Right Atrium and Right Coronary Artery

• Published in: Echocardiography (Mount Kisco, N.Y.) N.Y.), 2013-07, Vol.30 (6), p.E156-E160
• Main Authors: Tang, Kui, Shang, Quan‐Liang, Zhou, Qi‐Chang, Zhou, Jia‐Wei, She, Xiao‐Lin, Zhang, Ming
• Format: Article
• Language: English
• Subjects: cardiac tumor; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - etiology; Coronary Artery Disease - surgery; echocardiography; Fatal Outcome; Heart Neoplasms - complications; Heart Neoplasms - diagnostic imaging; Heart Neoplasms - surgery; Hemangiosarcoma - complications; Hemangiosarcoma - diagnostic imaging; Hemangiosarcoma - surgery; Humans; Male; Middle Aged; right atrium; right coronary artery; rupture; Rupture, Spontaneous - diagnostic imaging; Rupture, Spontaneous - etiology; Rupture, Spontaneous - surgery; Ultrasonography
• ISSN: 0742-2822; 1540-8175
• DOI: 10.1111/echo.12176

Primary tumors of the heart are rarely seen. Cardiac angiosarcomas are malignant tumors that almost always have a poor prognosis. Atrium rupture and coronary artery fistula are very rare complications of primary cardiac angiosarcoma. We describe a 57‐year‐old man suffering from primary cardiac angiosarcoma with spontaneous ruptures of the right atrium and right coronary artery (RCA). Theoretically, either of these ruptures invariably results in pericardial effusion and tamponade that is rare but potentially life threatening. In this instance, however, the patient might have developed fibrous adhesions resulted from previous bloody pericardial effusion. A massive pericardial effusion was localized, which consequently prevented cardiac tamponade and hemodynamic collapse. Echocardiography revealed the tumor progression leading to detectable infiltration of solid mass into the right atrial (RA) wall, which is close to RCA. And color Doppler displayed the flow into the pericardial cavity through a disrupted RA wall and perforated RCA. Echocardiography remains the primary method of choice for evaluation of cardiac masses. Mini‐ Primary tumors of the heart are rarely seen. Cardiac angiosarcomas are malignant tumors that almost always have a poor prognosis. We describe a 57‐year‐old man with primary cardiac angiosarcoma with spontaneous ruptures of the right atrium and right coronary artery. The rupture invariably results in pericardial effusion and tamponade which is rare but potentially life threatening. However, in this patient, previous fibrous adhesion resulted in contained collection, which consequently prevented tamponade and hemodynamic collapse.