Cardiac (Heart) Tumours

A cardiac tumour is a growth in the heart. Tumours that begin in the heart are rare, and about three quarters of them are benign. The most common in adults is the myxoma, usually attached inside the left atrium; in children it is the rhabdomyoma.

Even a benign heart tumour can be dangerous because of where it is: it can block blood flow or shed fragments that travel to the brain. Malignant primary tumours, mostly sarcomas, are very uncommon and hard to treat. Spread to the heart from cancers elsewhere is more frequent than either.

Symptoms

• Breathlessness, sometimes worse in certain positions
• Fainting or dizziness, especially on changing posture
• Palpitations or an irregular pulse
• A stroke, mini-stroke or blocked artery in a limb from a fragment of tumour
• Fever, weight loss, joint aches and tiredness, which myxomas can cause
• Swollen ankles or abdomen
• No symptoms, with the tumour found by chance on a scan

Causes and risk factors

Most myxomas arise without any known cause. A small proportion run in families as part of Carney complex, in which tumours are often multiple, occur at a younger age and can recur. Rhabdomyomas in infants are strongly associated with tuberous sclerosis and often shrink on their own. Papillary fibroelastomas are small growths on the valves, found mostly in older adults. Cardiac sarcomas have no clear cause. Secondary tumours come most often from lung and breast cancer, melanoma, lymphoma and leukaemia.

How it is diagnosed

• Echocardiogram: An ultrasound of the heart is the first and most useful test. It shows the size, attachment and movement of the mass.
• Transoesophageal echocardiogram: A probe in the gullet gives a closer view, particularly of the atria and valves.
• Cardiac MRI and CT: Help tell a tumour from a blood clot, suggest the tissue type and show invasion of the heart wall. CT also assesses the coronary arteries before surgery.
• PET-CT and biopsy: Used when a malignant tumour is suspected, to look for disease elsewhere and to obtain tissue if that will change management.

Treatment options

• Surgical removal: The standard treatment for myxoma and other benign tumours causing risk. It is open heart surgery on bypass, sometimes through a smaller incision, and is normally arranged soon after diagnosis because of the risk of embolism.
• Observation: Appropriate for rhabdomyomas in children that cause no obstruction, and for some small, fixed lesions found by chance.
• Treatment of malignant tumours: Surgery where complete removal is feasible, combined with chemotherapy and sometimes radiotherapy, planned by a sarcoma team.
• Treatment of secondary tumours: Directed at the original cancer, with drainage of fluid around the heart if needed.
• Follow-up echocardiograms: Yearly scans after myxoma removal, more closely in familial cases, because regrowth is possible.

When it is urgent

Call emergency services for sudden weakness of the face, arm or leg, difficulty speaking, sudden loss of vision, fainting, severe breathlessness, or a cold, painful, pale limb. With a known heart mass these may mean obstruction or an embolus and need the nearest hospital. They are not situations in which to travel.

Travelling to Türkiye for treatment

Once a myxoma is diagnosed, surgery is usually advised within days to weeks, and long flights before removal carry risk, so discuss any travel with your cardiologist first. If your doctors agree it is safe, a planned operation abroad needs about 2 to 3 weeks including early recovery, with follow-up echocardiograms at home. Suspected cardiac sarcoma needs a combined cardiac surgery and oncology opinion; a remote review of your imaging is a sensible first step before deciding where to be treated.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

Frequently Asked Questions