Cardiac Masses

Abstract

Echocardiography is an invaluable tool for cardiac structure evaluation. It is often the first imaging modality for assessing space-occupying masses in the heart. Point-of-care cardiovascular ultrasound has been increasingly used as an extension of the physical examination [1]. It allows non-invasive, real-time assessment of the heart at the bedside without the need for radiation [1]. Cardiac masses are considered to be benign in most circumstances. In fact, the majority of cardiac masses are discovered incidentally. However, some cardiac masses (such as left atrial myxoma) may lead to significant clinical consequences if left untreated. As a result, it is important to make a timely diagnosis, especially for those who are symptomatic (presenting with chest pain, syncope, or previous embolic events). Ultrasound allows for a detailed assessment of cardiac masses, including location (intracardiac vs. extracardiac), size, mobility, embolic potential, hemodynamic impact to surrounding structures, etc. Having gathered all this information, the physician may suggest further confirmatory testing such as transesophageal echocardiography, cardiac computer tomography or cardiac magnetic resonance imaging. However, if the cardiac mass appears to be complex and is difficult to assess by point-of-care ultrasound, a standard formal echocardiography with hemodynamic assessment should be pursued [2].