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CLINICAL IMAGE
Year : 2012  |  Volume : 136  |  Issue : 6  |  Page : 1063

Cardiac angiosarcoma discovered at a pacemaker implantation procedure


1 " Vasile Goldis" West University Faculty of Medicine Arad; County Emergency Hospital Baia Mare, Romania
2 County Emergency Hospital Baia Mare, Romania

Date of Web Publication4-Feb-2013

Correspondence Address:
Calin Pop
County Emergency Hospital, George Cosbuc street Nr 31, 430110, Baia Mare
Romania
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Source of Support: None, Conflict of Interest: None


PMID: 23391809

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How to cite this article:
Pop C, Fetcu A. Cardiac angiosarcoma discovered at a pacemaker implantation procedure. Indian J Med Res 2012;136:1063

How to cite this URL:
Pop C, Fetcu A. Cardiac angiosarcoma discovered at a pacemaker implantation procedure. Indian J Med Res [serial online] 2012 [cited 2019 Jun 25];136:1063. Available from: http://www.ijmr.org.in/text.asp?2012/136/6/1063/106941

A 77-year old man was sent for cardiac stimulation for syncope and complete atrioventricular block at County Emergency Hospital, Baia Mare, Romania. One hour after the procedure, the patient developed diffuse thoracic pain. Chest X-ray and ecocardiography were done for right ventricular perforation suspicion. There was no lead displacement, but ecocardiography showed a 5 mm anterior pericardial effusion and right atrial and ventricular endomyocardial masses that caused tricuspid valvular obstruction with a mean pressure gradient of - 9.11 mmHg [Figure 1], [Figure 2].
Figure 1. 2 D Echocardiogram showing a small pericardial effusion.

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Figure 2. Tricuspid Doppler flow with gradient.

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A CT-angio scanning confirmed the presence of an extensive filling defect in the right atrium and right ventricle with tricuspid valvular and right coronary ostium infiltration [Figure 3], [Figure 4]. The CT image was characteristic of primary cardiac angiosarcoma. This case was one of the rare cases in whom the diagnosis was made accidental but antemortem. Histopathological confirmation was not available. Patient was only medically treated (no oral anticoagulation) and died three months later with stroke, probably embolic from angiosarcoma.
Figure 3. CT angiogram with mass lesion (RV, LV, right & left ventricle; RA, LA, right & left atrium).

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Figure 4. CT angiogram with mass lesion (RV, LV, right & left ventricle; RA, LA, right & left atrium).

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    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

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