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Cardiac Angiosarcoma: From Cardiac Tamponade to Ischaemic Stroke - A Diagnostic Challenge

Vanessa Meireles Chaves1, Catarina Pereira2, Marta Andrade3

  • 1Department of Internal Medicine, Centro Hospitalar de S. João, Porto, Portugal.

European Journal of Case Reports in Internal Medicine
|May 30, 2019
PubMed

Insights

Cardiac angiosarcoma (CA), a rare heart tumor, presents atypically, often leading to delayed diagnosis. This case highlights the importance of thorough investigation for unexplained pericardial effusion to ensure timely diagnosis and improve outcomes for this aggressive cancer.

Area of Science:

  • Cardiology
  • Oncology
  • Pathology

Background:

  • Cardiac angiosarcoma (CA) is the most common primary malignant heart tumor.
  • Its rarity and atypical symptoms contribute to delayed diagnosis and poor prognosis.
  • Prompt diagnosis is crucial for managing this aggressive malignancy.

Purpose of the Study:

  • To report a case of cardiac angiosarcoma presenting with atypical symptoms.
  • To emphasize the importance of a multimodal diagnostic approach for unexplained pericardial effusion.
  • To highlight the diagnostic value of pericardial biopsy in suspected malignant pericardial disease.

Main Methods:

  • Case report of a 52-year-old woman with cardiac angiosarcoma.
  • Initial presentation with large pericardial effusion and inconclusive etiological studies.
  • Subsequent presentation with ischemic stroke, echocardiogram revealing right atrium rupture.
  • Surgical intervention followed by histological confirmation of angiosarcoma.

Main Results:

  • The patient presented with symptoms initially attributed to pericardial effusion.
  • A delayed diagnosis of cardiac angiosarcoma was made after the development of ischemic stroke and cardiac rupture.
  • Histological examination confirmed angiosarcoma as the cause of the patient's condition.

Conclusions:

  • Cardiac angiosarcoma is frequently overlooked due to its rarity and atypical presentation.
  • Pericardial biopsy is a valuable diagnostic tool for identifying malignant pericardial disease.
  • Close monitoring of patients with unexplained pericardial effusion and cardiac tamponade is essential.

Keywords:
Cardiac angiosarcomacardiac tamponadeischaemic strokepericardial biopsypericardial effusion

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