Cardiac mass
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CARDIAC MASS. By : Fauzi Muhammad Cardiovascular Technologist National Heart Institute. CARDIAC MASS. A few different pathologies may found in heart Vegetation Thrombus Cardiac Tumor. CARDIAC MASS. VEGETATION

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Cardiac mass

CARDIAC MASS

By :

Fauzi Muhammad

Cardiovascular Technologist

National Heart Institute


A few different pathologies may found in heart vegetation thrombus cardiac tumor

CARDIAC MASS

A few different pathologies may found in heart

Vegetation

Thrombus

Cardiac Tumor


Cardiac mass

CARDIAC MASS

VEGETATION

  • Intracardiac mass mainly attacted to heart vavle usually found in association with endocarditis.

    Mass Contain

  • Infective Organism

  • Fibrin

  • Platelet

  • Leucocyte


Cardiac mass

CARDIAC MASS

Location

- Valve

  • Chordae Tendinea

  • LVOT

  • Prosthetic valve

  • Ppm lead , catheters

  • Right side of IVS ( vsd )


Cardiac mass

CARDIAC MASS

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


Cardiac mass1

CARDIAC MASS

Negative features

- High ecogenicity

  • Nonvalvular location

  • Smooth surface or fibrillar

  • Non mobile

  • Absence of regurgitation


Cardiac mass2

CARDIAC MASS


Cardiac mass3

CARDIAC MASS


Cardiac mass4

CARDIAC MASS


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CARDIAC MASS

M-Mode

- Thickened,Dense and Irregular multiple echo line


Cardiac mass

CARDIAC MASS

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


Cardiac mass

CARDIAC MASS

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)


Cardiac mass

CARDIAC MASS

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 .


Cardiac mass

CARDIAC MASS


Cardiac mass7

CARDIAC MASS


Cardiac mass

CARDIAC MASS


Cardiac mass

CARDIAC MASS


Cardiac mass

CARDIAC MASS

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


Cardiac mass

CARDIAC MASS

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


Cardiac mass

CARDIAC MASS


Cardiac mass

CARDIAC MASS


Cardiac mass8

CARDIAC MASS

M-Mode

Multiple echo line filling the space behind the mitral valve leaflet during diastole


Cardiac mass

Doppler

To detect any haemodynamic changes cause by obstruction of mitral flow


Cardiac mass

CARDIAC MASS


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CARDIAC MASS

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

THANK YOU..


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