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COVID-19 infection and cardiac angiosarcoma: a dangerous combination-a case report
Santiago A Endara1, Gerardo A Dávalos1, Gabriel A Molina2
1Department of Surgery Division of Cardiothoracic Surgery, Hospital Metropolitano, Av. Mariana de Jesús Oe7/47 y Conclina, Edificio Diagnóstico 2000 tercer piso 3/3, Quito, Ecuador.
Insights
Primary heart angiosarcoma is a rare, aggressive cancer often diagnosed late. The COVID-19 pandemic exacerbated diagnostic challenges, leading to delayed treatment and poor outcomes in some cases.
Area of Science:
- Cardiovascular Pathology
- Oncology
- Infectious Disease Epidemiology
Background:
- The COVID-19 pandemic has severely impacted global healthcare systems, particularly in resource-limited settings.
- Primary heart angiosarcoma, a rare and aggressive malignancy, presents with vague symptoms, increasing the risk of delayed diagnosis.
- Limited healthcare capacity and the overwhelming focus on COVID-19 can exacerbate diagnostic delays for other critical conditions.
Observation:
- A 28-year-old female presented with cough, hemoptysis, and CT findings suggestive of pneumonia.
- Misdiagnosis occurred due to the prevailing COVID-19 pandemic context in Ecuador.
- The patient was ultimately diagnosed with primary heart angiosarcoma but suffered fatal complications.
Findings:
- Primary heart angiosarcoma is frequently diagnosed at advanced stages with metastasis.
- Vague and misleading clinical manifestations contribute to the high rate of missed diagnoses.
- Pandemic conditions can significantly worsen the diagnostic timeline for rare diseases.
Implications:
- Increased clinical awareness of primary heart angiosarcoma is crucial, even during pandemics.
- Differentiating rare conditions from COVID-19 is vital to prevent adverse patient outcomes.
- Prompt diagnosis and management are critical for improving survival rates in cardiac malignancies.
Background:
The COVID-19 pandemic has strained all medical systems, especially in countries like Ecuador, where health services were already limited. These conditions, combined with a deadly and unusual disease, like primary heart angiosarcoma, can lead to severe outcomes. Angiosarcomas represent the most common and aggressive primary malignant heart tumor; regretfully, its clinical manifestations are vague and can be easily missed. Most patients become symptomatic when there is local invasion, embolization, or metastases, leading to late diagnosis and poor survival. High clinical awareness, adequate diagnosis, and prompt treatment are vital in these rare diseases, in which time is of paramount importance.
Case Presentation:
We report the case of a 28-year-old female who had cough, hemoptysis, and ground-glass opacities in the CT (computed tomography). Since Ecuador is in the middle of this pandemic, she was misdiagnosed and mistreated. Primary heart angiosarcoma was diagnosed, and regretfully, the patient suffered multiple complications due to diagnosis and died.
Conclusion:
To this day, most cardiac angiosarcomas are found in a late-stage with distal metastasis and advanced local invasion. Sadly, this tumor is frequently missed due to its incidence and broad-spectrum of clinical symptoms. Considering that its manifestations can be misleading, misdiagnosis can occur, especially in pandemic times. Therefore, knowledge of other pathologies prevents COVID-19 from overshadowing other diagnoses, hence preventing delayed diagnosis or even misdiagnosis and consequent adverse outcomes for patients.
Supplementary Information:
The online version contains supplementary material available at 10.1186/s43057-021-00042-7.
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