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Cardiac Angiosarcoma - Symptoms, Causes, Diagnosis, and Treatment

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Cardiac angiosarcoma is a heart tumor that blocks the blood from flowing into and outside the heart chambers.

Medically reviewed by

Dr. Isaac Gana

Published At September 30, 2022
Reviewed AtJanuary 18, 2024

Introduction

The heart is divided into four chambers. The above two chambers are the left and right atrium, and the lower two are called the left and right ventricles. Sarcoma is a kind of cancer that begins to form in the soft tissues of the body or even the bones. Angiosarcoma refers to the type of sarcoma formed in the cells of the blood vessels. Cardiac angiosarcoma is one of the most common types of cardiovascular sarcoma. The majority of cardiac angiosarcomas occur in the right upper chamber or the atrium of the heart.

Due to an angiosarcoma in the heart, the blood is stopped from flowing smoothly out of the heart and into the body parts. This interaction in the blood flow can lead to chest pain and inflammation in the abdomen, extremities, and other joints. Cardiac angiosarcoma is a type of cancer of the heart that has the potential to spread to other parts of the body. It forms clumps in the blood vessels, resulting in interrupted blood flow. Cardiac angiosarcoma can either be primary or secondary. Primary cardiac angiosarcoma is very rare. On the other hand, secondary cardiac and sarcoma is quite common and starts growing elsewhere in the body and then lodgers in the heart and other structures of the heart such as the cardiac blood vessels.

What Are the Signs and Symptoms of Cardiac Angiosarcoma?

The signs and symptoms of cardiac angiosarcoma depend on the tumor's location. Cardiac angiosarcoma can be present within the heart called intracavity or outside the heart. Additionally, cardiac and sarcoma can be present in one or more than one chamber of the heart. Cardiac angiosarcoma can also be present in the heart's muscles or the pericardium's protective sac around the heart. The clinical manifestations of cardiac angiosarcoma are parallel to other cardiovascular diseases. This is why it is vital to get the heart checked by the healthcare provider in case there is the presence of any of the symptoms so that it can be distinguished from cardiovascular disease or the presence of cancer which will need immediate treatment.

Mentioned below are some of the signs and symptoms of cardiac angiosarcoma (Heart Cancer):

  • Chest pain.

  • Palpitations.

  • Bloating of the abdomen.

  • Swelling in the legs and feet.

  • Arrhythmia.

  • Fever.

  • Weakness.

  • Fatigue.

  • Excessive sweating.

  • Abnormal heart rate.

  • Shortness of breath.

  • Stroke.

  • Formation of blood clots.

  • Swelling of ankles and other joints.

  • Distended neck veins.

  • Coughing of blood.

  • Hoarseness of voice.

  • Swelling of the face.

  • Unintentional weight loss.

  • Bluish discoloration of fingertips.

  • Tiredness.

  • Fainting.

  • Enlargement of the heart.

  • Heart attack.

  • Unexplained cardiac arrest.

  • Enlarged fingers.

  • Abnormal curvature of the nails.

What Is Cancer Around the Heart?

Cancer around the heart generally refers to tumors that develop in the tissues surrounding the heart or nearby structures rather than originating directly within the heart muscle itself. These tumors can arise from various tissues, including the lining of the heart (pericardium), the outer layer of the heart (epicardium), or nearby structures like the mediastinum (the space between the lungs where the heart is located) or the lungs themselves.

There Are Two Main Types of Tumors That Can Affect the Tissues Around the Heart:

1. Primary Tumors:

These tumors originate in the tissues surrounding the heart or in adjacent structures like the mediastinum or lungs. Primary tumors around the heart are extremely rare, with sarcomas (such as angiosarcoma) being one of the types that can develop in the heart's vicinity.

2. Metastatic Tumors:

More commonly, cancer that originates in other parts of the body (like the lungs, breast, or other organs) can spread or metastasize to the tissues surrounding the heart. When cancer metastasizes to these areas, it can form secondary tumors, impacting the structures around the heart.

What Are the Causes of Cardiac Angiosarcoma?

Cardiac angiosarcoma is one of the rarest cancers known to date, and due to this, there are no definitive causes that have been found and documented for cardiac angiosarcoma. Furthermore, only a few pieces of research show a link between previous radiotherapy treatment and the development of cardiac angiosarcoma. Therefore, a few of the causes are currently being studied for their association with cardiac angiosarcoma.

  • Excessive use of tobacco.

  • Increase exposure to the sun.

  • Abnormal cell division.

  • Genetics.

  • Infection due to certain viruses.

  • Benzene exposure.

  • Ingestion of poisonous plants.

  • Radiation therapy.

  • Immune system irregularities.

  • Abnormal regulation of cell growth.

  • Intake of toxic mushrooms.

How to Diagnose Cardiac Angiosarcoma by a Doctor?

Various methods are used for diagnosing cardiac angiosarcoma, and to some degree, they are successful. Based on the presenting clinical manifestations of the patient and taking into account a complete physical examination and medical history, mentioned below are some of the diagnostic tools used to diagnose cardiac angiosarcoma. An echocardiogram for the ultrasound of the heart is a non-invasive test that studies the wave of the heart motions chambers and valves. This is one of the most useful diagnostic tools for cardiac angiosarcoma because it allows the health care provider to locate the tumor and determine its exact size. A transesophageal echocardiogram is another diagnostic tool guided down the throat and the esophagus directly into the heart, giving a much more detailed picture.

Electrocardiogram, also called an EKG for ECG, records the heart's electrical activity and shows any abnormal heart sounds or heart murmurs. In addition to this, it also observes any damages present in the cardiac muscles. A biopsy is frequently necessary for diagnosis, in which a pathologist takes a tiny sample of the suspected tumor or damaged tissue and examines it under a microscope. Collaboration among various specialists like cardiologists, oncologists, and surgeons is common due to the rarity and complexity of cardiac angiosarcoma. This thorough diagnostic approach helps confirm the presence of angiosarcoma cells and guides subsequent treatment decisions tailored to the individual patient's condition.

A computed tomography scan combines X-ray and technology to produce slices or horizontal and axial images of the body showing a detailed picture of the desired organ. Along with the size and location, other in-depth features can be understood with the help of a CT or computed tomography scan. Magnetic resonance imaging for MRI is a diagnostic tool that uses computers and radio frequencies to produce a detailed image of the structures of the body. An x-ray of the chest uses electromagnetic energy to detect any enlargement of the heart or condition of the lungs. Cardiac catheterization is a procedure where X-rays are taken after a contrast dye is injected into the heart's arteries. This procedure helps detect any abnormalities of the cardiac arteries and blood vessels. A biopsy of the heart refers to a tiny amount of tissue examining it under a microscope that may suggest the presence of cancer if the pathologist analyses and studies the tissue. Complete blood picture. Diagnosis often requires a biopsy, where a small sample of the suspected tumor or A pathologist removes the afflicted tissue and examines it under a microscope.

How Is Cardiac Angiosarcoma Treated?

Today, there are no established treatment modalities for cardiac angiosarcoma due to race incidents in the population. Nevertheless, few multidisciplinary approaches and management therapies are both non-invasive and invasive. Therefore, mentioned below or a few possible treatment options based on the individual's current condition for cardiac and sarcoma.

  • Radiotherapy.

  • Chemotherapy.

  • Surgery.

  • Heart transplantation.

  • Autotransplantation.

  • Open-heart surgery.

  • New drug studies and trials.

Conclusion

Cardiac angiosarcoma is a sporadic kind of cancerous tumor present in the heart. The clinical manifestations of patients are based on the size and the extent of the lesion. Therefore, a diagnosis of cardiac angiosarcoma should be made immediately for a more successful treatment outcome. In addition, members of the affected individual should undergo cancer screening due to cardiac angiosarcoma being an inherited disease.

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Dr. Isaac Gana
Dr. Isaac Gana

Cardiology

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