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Overview
Tumour is essentially an outgrowth on any tissue or organ surface. When this tissue outgrowth occurs on the surface of the cardiac tissues, then it can be medically termed as a cardiac tumour. Usually, the heart chambers or the heart valves are the places where these protrusions may be found. Amongst the different tumours, cardiac tumours are the rarest and not heard of that frequently.
Types of cardiac tumours
Like all other tumours, cardiac tumours also have two general types. The names of those types of tumours are;
- Benign tumour: These types of tumours are non-cancerous in origin. They can be of any size depending upon the time of their first occurrence. They do not spread to localized or distant organs.
- Malignant tumour: These types of tumours are cancerous and therefore have the property of metastasizing, which is, essentially, spreading to other sites. They are the hardest to treat and the success rate of complete remission and non-occurrence for a second time cannot be termed as satisfactory.
According to the location of its origin, tumours can be divided into two divisions. They are known as;
- Primary tumour: The tumours that originate in the cardiac site and remains there, is known as a primary tumour. A most common type of benign cardiac tumour is myxoma. They are more prevalent in women than in men. Other non-cancerous primary tumour can be stated as papillary fibroelastomas, fibromas, rhabdomyomas, hemangiomas, teratomas, lipomas, paragangliomas and pericardial cysts.
- Secondary tumour: The tumour which originates elsewhere and spreads to the cardiac tissues are known as secondary tumours. Most often, their site of origin can be seen to be the lungs, stomach, breast, kidney, colon, and liver. They are usually related to lymphoma, leukemia or melanoma origins.
Most cardiac tumours are benign. However, sometimes little pieces of them can fall in the bloodstream, get carried away and cause an obstruction in the way of blood supply to the major organs. This condition is called embolism.
Causes
The cause of a tumour in the heart may be varied and usually is found out to be an external factor or reason that generates this type of outgrowth. Some of the known reasons can be stated as;
Genetic predisposition:
Usually, a person inflicted with a cardiac tumour has been seen to have some members in the previous generation with the same disease. Nearly 10% of cardiac tumours are passed down in generation bloodlines.
Secondary effects:
The tumours may occur due to an effect of another disease, namely, NAME Syndrome, Carney Syndrome, and LAMB Syndrome which causes this inflammation in the cardiac tissues.
Cell overgrowth
Most often, cardiac tumours are found to generate simply by the uncontrolled division of cells, or metastasizing from another location of the cardiac valves and muscles.
Tobacco
Tobacco contains nicotine, which is a known agent of cancer-causing chemicals. Smoking, inhalation, and chewing of tobacco products may cause tumour in the respective organs, which may spread to the cardiac tissues.
SYMPTOMS
The symptoms of cardiac tumour are not very specific. Sometimes, there may not be any symptoms at all. At times, symptoms of cardiac tumours may surface suddenly and may resemble other heart diseases. Their intensity may range from mild to severe. The general indicators of cardiac tumours may resemble that of endocarditis and can be noticed as;
- Difficulty in breathing when lying in a flat position or when taking rest.
- Sudden light-headedness, fainting, or unsteadiness.
- Very fast heart rate or Palpitations.
- Chest pain
- Fever or cough.
- Unintentional weight loss.
- Pain in joints.
- Alteration of the colour of the finger on application of pressure, or turning blue. (Raynaud’s phenomenon)
- Enlargement of the finger’s soft tissue with the curving of the nails.
- Inflammation of the leg, ankle, or abdomen.
DIAGNOSIS
The rarity and similarity to other cardiac diseases and conditions make the diagnosis of cardiac tumours a daunting task. Usually, people with heart murmurs, irregular heart rhythms or baffling symptoms of heart failure are diagnosed with cardiac tumours only after studying their family case history, symptoms and a collection of diagnostic tests. If in cancer patients, sudden malfunctions of the heart are seen, then the cause may be attributed to cardiac tumours.
Your physician may prescribe the following tests for you if he or she suspects a cardiac tumour:
- Blood tests: Used to detect the molecular markers of cancerous origin.
- Chest X-ray: Used to perform a rudimentary recognition of cardiac tumours.
- Echocardiogram: An “echo” of high-frequency ultrasound waves is used to produce a moving picture of the heart and cardiac valves.
- Electrocardiogram: this test can record the electrical activity of the heart and shows arrhythmias or dysrhythmias, which are abnormal rhythms of the heart.
- Cardiac catheterization: A catheter is introduced into the heart and test is done to identify the type of tumour occurred.
- Heart MRI: Magnetic Resonance Imaging, or MRI, provides supplementary data for analysis in the form of 3D images.
- CAT scan: A computer-assisted X-ray machine look for abnormalities in the heart by taking multiple photos and rendering a digital cross-section of the organ tested.
- Coronary angiography: This test is not very well-known, but it can produce an outline image of a cardiac tumour with the help of X-rays.
The oncologist will decide on the course and duration of the treatment after reviewing all the results.
RISK FACTORS
Surgical removal of the cardiac tumour is an invasive procedure and therefore risks are present. The associated risks may include:
- Bleeding
- Blood clots
- Arrhythmia
- Secondary infection
- Stroke
- Death
- Return of the tumour.
- Embolism.
POST-OPERATIVE CARE
After the procedure, the patient may be kept in an ICU for a day or two for observation, depending upon the severity of the operation. During this time, he or she will be connected to heart, blood pressure, body temperature, and inhalation monitor. After the patients start to perform motor functions by themselves, he or she will be moved to the general ward for further healing. Other things you may need to take care of will be;
- Taking extreme care not to infect the surgery wound. The hospital may arrange for the periodical dressing of the wound.
- You may face suspended bowel movement, which is usually after a long surgery. You may be given purgatives or your diet may be changed according to your physician.
- You will not be allowed to lift heavy things until the physician permits you. Sudden blows to the chest are also a big no-no.
- Blood pressure, breathing, and heart rate will be cross-checked from time to time.
- The physician may provide you painkillers if you feel any pain.
- An ECG will be done every year to ensure the tumour has not re-emerged or no new growth is taking place.
In the case of open-heart surgery, the usual time of recovery ranges from 5- 6 weeks. For robotically assisted surgery, this time may get reduced to 2 to 3 weeks.
TREATMENT
Cardiac tumours cause problems with the blood flow of the heart; therefore, the treatment of choice will be the surgical removal of the outgrowth. However, medicines may be given to reduce the growth of the tumour. Chemotherapeutic treatment is rare but not unheard of.
After the decision has been taken to go ahead with the surgery, you should perform the following steps which may also coincide with the physician’s instructions;
Before surgery
You need to ask your physician about any medication that you were already taking and should you continue doing that. Around two weeks before the final date, if you have health cover or insurance coverage, inform the executives and the business department of the hospital for due action. Your physician may perform some pre-operative tests and suggest some additional medicines.
A day before the surgery, you will be checked for a regular bowel movement. Before surgery, you will not be provided with any food. The hospital staff may shave off the hair from the region where the incision will be made and any jewelry, makeup, and other accessories before the operation will be removed. It is better to have someone with you for the period of the surgery and resting.
During the procedure
- You will be taken to the operation theatre and laid in the table, chest side up.
- You will be given general anaesthesia and that will make you unconscious.
- Your heart will be linked to a heart-lung machine which will continue the functions of it.
- The surgeon will expose your torso cavity and locate the affected part by the tumours.
- The tumour and the surrounding tissue will be removed.
- The operated part will be sewn back.
- A defibrillator may be used in case of emergency situations.
The total time taken in his procedure can reach up to three to five hours. In some hospitals, the procedure can even be performed by robotic arms which are minimally invasive and requires less time in the hospitals.
FACTORS AFFECTING COST
As the removal of the tumour requires access to the heart, the charges may be similar to open-heart surgery. The cost of the treatment may depend on the following factors:
- The charges of surgery.
- The cost of medicines.
- The fees of the oncologist and surgeon.
- The charge of the operating room, residing ward, etc.
- The type of surgery applied (open-heart, minimally invasive, or robotically assisted).
FAQ
Yes, they are. In some cases, surgery is the only option to remove these outgrowths.
Myxoma, a kind of benign tumour occurs in the cardiac chambers. These tumours are found to be hereditary and can occur in males of age bracket 20.
Several problems may arise because of an un-operated cardiac tumour. The tumour may block blood flow in the heart, causing blood pressure. Pieces of a tumour mass can reach other sites and cause an embolism.
