Metastases to the heart are more common than primary cardiac tumors. Many patients with cardiac metastases are asymptomatic but some present with one or more cardiac symptoms.
Tumors that may have cardiac metastases include:
(1) malignant melanoma
(2) acute leukemia
(3) lung cancer
(4) breast cancer
(5) renal cell carcinoma
Clinical features of a cardiac metastases may include:
(1) pericardial effusion with or without tamponade
(2) heart failure
(3) cardiomegaly
(4) tachycardia
(5) arrhythmias
The tumors usually occur in a patient with evidence of cancer, usually with metastatic disease. The new onset of cardiac findings in a patient with cancer should trigger an assessment for cardiac metastases.
Fluid drained from the pericardium should be sent for cytology.
Differential diagnosis:
(1) cardiac complications of chemoradiation
(2) pre-existing heart disease
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