Primary Cardiac Angiosarcoma Presenting as Cardiac Tamponade

Malignant primary cardiac tumors are rare. The most common presenting symptom is dyspnea, which is non-specific. These tumors pose a significant diagnostic challenge, which when coupled with rapid disease progression can result in significant morbidity and mortality. Appearance of cardiac masses on CT and echocardiography can be non-specific. Cardiac MRI can help delineate cardiac tumors but definitive diagnosis requires mediastinal exploration and biopsy. Treatment includes radical resection followed by radiotherapy and chemotherapy along with targeted therapy. Metastasis often precludes candidacy for surgery, therefore, early diagnosis is pivotal. We present a patient with primary cardiac angiosarcoma who initially presented with cardiac tamponade and at time of diagnosis was not a surgical candidate. We aim to bring greater awareness to malignant primary cardiac tumors in hopes of increasing diagnostic suspicion to facilitate earlier diagnosis and treatment intervention.