Obstruction as Unusual Presentation of Cardiac Tumor - Two Cases

Primary tumors of the heart are rare and 80 to 90% of cases are benign. Due to its histological nature, in pediatric age, the most frequent is rhabdomyoma that is associated with tuberous sclerosis, followed by fibroma, teratoma, vascular tumors, myxoma, more frequent in adults and pericardial teratoma. Size, growth rate, and location determine clinical manifestations, time of diagnosis and associated morbidity or mortality.

Echocardiography is essential for diagnosis and decision making.

Symptoms of obstruction to blood flow through the valve orifices, the possibility of causing serious arrhythmias or the possible embolization of or part of the tumor are decisive for the surgical indication.

Two patients are presented, an infant with a diagnosis from the newborn period of tumor in the left outflow tract with clinical expression after the first month of life, which motivates his surgical intervention. The histological study determined that it was a rhabdomyoma.

The second case is a schoolboy whose heart murmur, hepatomegaly was detected with a history of syncope, and when performing an echocardiogram, a large right atrial tumor was detected. After the histological study, a high-grade endocardial myxoid fibrosarcoma was diagnosed, for which chemotherapy treatment was required.

The symptoms prior to the detection of cardiac tumors are not related to their histological nature.

Keywords: Tumor, heart, surgery.