Summary : Will the heart also get tumors? It's not too late to know.

"What! The heart will have a tumor too! "This is probably the first reaction that many people see in this article.
not to be surprised, not only do ordinary people not know much about heart tumors, but many cardiac surgeons are not familiar with heart tumors.
reported that in 2014, of the 66,453 cardiovascular operations performed in Japan, only 602 were heart tumor operations.
, it can be seen that heart tumors are relatively rare.
today's editor summarized the main types of heart tumors, clinical manifestations, surgical treatment methods, read this article, so that you no longer "know nothing" about heart tumors! Figure 1: Heart Tumor Model Map (Picture Worm Creative) 01 What tumor is a heart tumor? Heart tumors are a relatively rare condition with a very low probability of detection during clinical autopsies.
Heart tumors are divided into two categories, one is primary, of which about three-quarters are benign tumors, the most common are mucus tumors and lipomas, and the other quarter are malignant tumors, the vast majority of sarcoma, may develop anywhere in the heart, and there is no gender difference.
The other category is secondary heart tumors, all of which are malignant tumors, generally metastasis of malignant tumors in other parts of the body, the incidence of which is much higher than primary heart tumors, the most common being melanoma, followed by leukemia, lymphoma, breast cancer and lung cancer.
the asymptomatic stage of heart tumor heart tumor may cause a variety of complications, depending on its anatomical location, the size of the range of the affected will also have different manifestations.
Patients in the early stages of heart tumors are generally asymptomatic, to the progression period may appear more non-specific symptoms, mainly hindering blood flow and the function of the heart valve, so it will lead to insufficient blood supply to the heart, local invasion led to arrhythmic disorders.
or a blood clot around the tumor can trigger embolisms in the brain or coronary arteries, and the whole body may experience breathing difficulties, arrhythmic disorders, or even cardiac arrest.
03 primary heart tumor primary heart tumor is rare, the prevalence rate is about 0.0017% to 0.028%.
in addition to mesothelioma or cardiac ensty primary malignancies, primary malignant heart tumors include a variety of sarcoma and lymphoma, and heart metastasis is not uncommon.
clinical characteristics of primary malignant heart tumors depend on the location, size, immersion, brittleness and growth rate of the tumor.
mostly sarcoma, which usually progresses rapidly and leads to premature death through myocardial immersion and distant metastasis of the circulatory system to the lungs, lymph nodes and liver.
can be treated surgically if possible, and patients can reportedly survive long-term after complete removal, especially low-grade sarcoma.
patients with primary heart lymphoma can have heart pressure plugs, atrial fibrillation, right heart failure and upper cavity venous syndrome, and their prognosis is better than sarcoma, 40% of patients are effective through systematic treatment.
therefore, when a good malignant heart tumor is identified, a diagnostic diagnosis must be made.
according to an analysis of the clinical efficacy of primary heart disease published in the Chinese Journal of Evidence-Based Cardiovascular Medicine in 2020, primary heart disease can achieve good long-term results by surgically removing it in a timely manner.
149 cases of heart tumors reviewed in the article were successfully removed, surgical time (102.4 x 34.5) min, in vitro circulation time (59.1 x 23.5) min, aortic blocking time (28.5 x 17.8) min, and postoperative hospitalization time (11.5 x 5.4) d . Table
1 Primary heart tumor pathology type, surgical condition and prognosis The author of this article said in this article, "Surgical excision is the preferred treatment for primary heart tumor, as long as there are no taboos, should be treated by emergency or limited-term surgery, the treatment effect mainly depends on the type of heart tumor and recurrence."
heart benign tumor, especially mucus tumor surgery effect is very good, the recurrence rate is low after surgery, the long-term survival rate is high, and the heart malignant tumor progresses quickly, the recurrence rate is high, the prognosis is bad.
04 secondary heart tumors in general, about 10% of non-cardiac malignancies metasninsate to the heart, and only 10% of them develop symptoms and signs of cardiac dysfunction.
, only about 1% of malignant tumors show heart-related clinical symptoms, most commonly in patients with lung cancer, breast cancer, lymphoma and leukemia.
malignant melanoma and malignant reproductive cell tumors also often spread to the heart, often caused by tumors directly immersed or through cavity veins into the right advent.
heart or cardiac metastasis should be considered whenever such patients develop new cardiovascular symptoms or signs quickly.
new signs and symptoms may also point to the heart's affected areas.
90% of cases can have cardiac enumeration fluid, which does not necessarily lead to cardiac congestion.
if a patient has heart symptoms, the prognostics are often poor.
05 three typical clinical symptoms, see if you have! The discovery of a heart tumor may be due to associated heart symptoms, or it may be due to seemingly unrelated problems or medical examinations.
symptoms are usually associated with the location of heart tumors and can sometimes produce systemic symptoms.
Usually, tumors appear in three ways: (1) systemic symptoms: fever, joint pain, weight loss, fatigue, and other symptoms, as well as side tumor syndrome (PCT) (2) heart symptoms: tumors interfere with myocardial function or blood flow, resulting in abnormal heart rhythms;
symptoms include difficulty breathing, chest discomfort, and fainting.
(3) embolism: a pulmonary and/or systemic thrombosis.
are the main diagnostic elements of clinical 06? Clinical symptoms can often help determine the cause of heart lumps or lesions, such as heart thrombosis is often accompanied by arrhythmic disorders.
However, if the heart lump is essentially a tumor, the cause can usually be determined by four factors: (1) the age of the patient: such as transverse fibroids and fibroids are the most common benign heart tumors in children.
(2) Epidemiological investigation: A 70-year-old man who has experienced a frontal myocardial infarction, poor left room activity, etc. is more likely to suffer from an endocardial thrombosis.
(3) tumor location: see Figure 2 for details of the diagnosis.
Figure 2: Overview of the subtype distribution of heart lumps by anatomical location.
identified as a heart tumor, echo cardiac arrest remains the primary analytical tool and often requires MDCT and/or CMR to confirm or rule out diagnosis.
note that in CMR, T1 and T2 weighted sequences indicate the chemical micro-environment within the tumor, which helps to identify tumor properties.
need to use coronary angiitis to assess tumor blood supply and blood vessels from or invasive epithal membranes.
this is an important step in the plan to remove the tumor.
can be found in Table 2.
Table 2 Common cardiac block tissue characteristics and cardiovascular magnetic resonance imaging ( 8 ) 07 Surgical precautions Once a heart tumor is diagnosed, as long as there are no taboos should be operated on as soon as possible.
surgical excision is the most effective treatment for primary heart benign tumor, preoperative surgery to reduce positional changes and heart movement to avoid tumor shedding between organ embolism.
Middle-aged and elderly patients with mucus tumor due to old age, organ function loss, poor cardiopulmonary function, more preoperative complications, perioperative complications are also more common, after surgery easy to combine lung oozing, hypoxemia, lung infection, hypoproteinemia, malnutrition, resulting in longer hospital stay, increased risk of perioperative period.
But old age, incomplete heart function, complications are not surgical taboos, early grasp of the timing of surgery and strengthen perioperation management to reduce lung oozing, treatment of complications can improve the success rate of surgery and reduce complications, the prognosis is good.
heart tumor surgery after opening the chest to avoid stimulating the heart, avoid moving, squeezing the heart, so as not to cause organ embolism when the tumor falls off.
In addition to the heart cavity tumor in addition to the complete removal of the tumor should pay attention to the tumor tired and adjacent structural tissue, the heart tumor often squeezes or invades the room valve, resulting in incomplete valve closure, valve ring expansion, surgery to remove the tumor must explore the opening and closing of the chamber valve, if the valve ring enlargement, valve reflow obvious, should actively perform valve forming.
008 knot Although heart tumors are rare, even benign tumors can lead to serious complications such as in-heart obstruction and fatal arrhyth arrhythmics.
, the presence of heart tumors reminds us to be aware of and study new organisms of the heart, rapidly developing cardiac fluid, or resumable rapid-progressing heart failure.
imaging plays a central role in the assessment of suspicious tumors, and as multimodal imagery becomes easier to obtain, we are able to better accurately distinguish heart-specific lesions to provide optimal medical management.
not only helps to identify possible causes, but also can plan further diagnostic studies and guide management methods.
We are also looking forward to the era of artificial intelligence diagnosis and treatment to facilitate early and accurate diagnosis, and 3D printing to promote better identification of tumor growth, which may provide the most accurate basis for better preoperative planning.
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