Download cardiac mass

CARDIAC MASS
By :
Fauzi Muhammad
Cardiovascular Technologist
National Heart Institute
CARDIAC MASS
A few different pathologies may found in heart
Vegetation
- Thrombus
- Cardiac Tumor
-
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VEGETATION

Intracardiac mass mainly attacted to heart vavle usually found
in association with endocarditis.
Mass Contain
-
Infective Organism
Fibrin
Platelet
Leucocyte
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Location
- Valve
-
-
Chordae Tendinea
LVOT
Prosthetic valve
Ppm lead , catheters
Right side of IVS ( vsd )
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Size
-
Variable – Large with Fungal Infection
Echo Examination
- 2 D
Positive features
-
-
Visualized as a mobile Mass , oscillating.
Attached to valvular surface and collapsing into one of cardiac
chamber during systole
Associated tissue changes - thickened , calcified
Irregular shape ,amorphous .
Low reflectance
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Negative features
- High ecogenicity
- Nonvalvular location
- Smooth surface or fibrillar
- Non mobile
- Absence of regurgitation
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M-Mode
- Thickened,Dense and
Irregular multiple echo
line
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Color Doppler
-
To detect association valve abnormalities such as regurgitation
Role of echo examination
-
To detect
To assess progresion , effect of medication
Valve complication
Ruptured , Perforation
- Valvular regurgitation / stenosis
Abscess formation
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THROMBUS
Blood that been converted from liquid to a solid state
Precipitating condition
-
Dilated chamber and/or reduce contractility
Blood stagnation will result in thrombus formation
Other cause
DCM
- Post MI
Valve disease – MS
Prosthetis valve (mechanical/bio)
Arrhythmias ( Af,Flutter)
-
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Morphology
-
Bright , well define, possible mobile mass, attach to cardiac
wall or flat thickening in cardiac wall (mural)
Echo Examination
Usually clear, identifiable edges, the wall motion abnormal
(akinetic/ dykanetic)
If left atrium common location at posterior near LAA
Amorphous ,echogenic structures with variable shape
May be multiple and mobile .
Pw doppler to assess flow velocity within LAA < 20cm/sec
increase the embolic risk .
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Cardiac Tumor
2 type
-
-
Benign eq: myxoma , lymphoma, Fibroma
Malignant - primary – Common sarcoma
Secondary – Metastase of other organ
Lung Ca , Renal Ca
- 80% cardiac Tumor - Benign
Myxoma
80% of cardiac tumor .
-
-
Location
75% - LA
20% - RA
Rare at ventricle
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LA Myxoma
Role of echo examination
-To look for :
Size
Extension/and Invasion within and outside the heart
Valvular involment and competancy
Ventricular function
Pericardial effusion
2D
All 4 Chamber should be visualized
Location : Common origin from mid portion of the atrial septal atttach fosa
ovale(narrow stalk)
Shape : Polypoid ,pedunculated ,round or oval ,soft surface
Size
: Various
Mobility : May prolapes during diastole
Density : Echogenic and occasional calcified
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M-Mode
Multiple echo line
filling the space behind
the mitral valve leaflet
during diastole
Doppler
To detect any
haemodynamic changes
cause by obstruction of
mitral flow
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Summary
Echo examination gold standard to diagnose
and manages patient with cardiac mass but
other modality are needs to confirm the
diagnosis such as :
Contrast echo ,TEE, 3D ,MRI ,CT Scan ,Lab
Ix , Clinical features .
THANK YOU..