Cardiac tumours simulating collagen vascular disease

Area of Science:

• Cardiology
• Rheumatology
• Pathology

Background:

• Cardiac tumors, both benign and malignant, can present with systemic symptoms mimicking collagen vascular diseases.
• Misdiagnosis can lead to delayed or inappropriate treatment for patients with cardiac tumors.

Observation:

• Three cases of cardiac tumors (two malignant, one benign) presented with symptoms resembling collagen vascular diseases.
• A review of 15 similar cases revealed misdiagnosis of various autoimmune conditions before the correct cardiac tumor diagnosis.
• In half of the reviewed cases, cardiac tumors were only identified post-mortem.

Findings:

• Collagen vascular disease diagnosis requires corroborative laboratory data; its absence warrants further investigation.
• Standard echocardiography (M-mode and cross-sectional) may not exclude malignant cardiac tumors or atrial myxomas.
• Some patients with suspected but unconfirmed autoimmune disease, who actually have cardiac tumors, may show improvement with steroid treatment.

Implications:

• Clinicians should consider cardiac tumors in patients with systemic upset and suspected collagen vascular disease, especially without laboratory confirmation.
• Advanced imaging and potentially biopsy may be necessary to definitively diagnose cardiac masses.
• This highlights the importance of a comprehensive diagnostic approach to avoid potentially fatal delays in cardiac tumor diagnosis.