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CARDIAC MASS

CARDIAC MASS. By : Fauzi Muhammad Cardiovascular Technologist National Heart Institute. CARDIAC MASS. A few different pathologies may found in heart Vegetation Thrombus Cardiac Tumor. CARDIAC MASS. VEGETATION

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CARDIAC MASS

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  1. CARDIAC MASS By : Fauzi Muhammad Cardiovascular Technologist National Heart Institute

  2. CARDIAC MASS A few different pathologies may found in heart Vegetation Thrombus Cardiac Tumor

  3. CARDIAC MASS VEGETATION • Intracardiac mass mainly attacted to heart vavle usually found in association with endocarditis. Mass Contain • Infective Organism • Fibrin • Platelet • Leucocyte

  4. CARDIAC MASS Location - Valve • Chordae Tendinea • LVOT • Prosthetic valve • Ppm lead , catheters • Right side of IVS ( vsd )

  5. CARDIAC MASS Size • Variable – Large with Fungal Infection Echo Examination • 2 D Positive features • Visualized as a mobile Mass , oscillating. • Attached to valvular surface and collapsing into one of cardiac chamber during systole • Associated tissue changes - thickened , calcified • Irregular shape ,amorphous . • Low reflectance

  6. CARDIAC MASS Negative features - High ecogenicity • Nonvalvular location • Smooth surface or fibrillar • Non mobile • Absence of regurgitation

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  11. CARDIAC MASS M-Mode - Thickened,Dense and Irregular multiple echo line

  12. CARDIAC MASS Color Doppler • To detect association valve abnormalities such as regurgitation Role of echo examination • To detect • To assess progresion , effect of medication • Valve complication Ruptured , Perforation - Valvular regurgitation / stenosis • Abscess formation

  13. CARDIAC MASS THROMBUS Blood that been converted from liquid to a solid state Precipitating condition • Dilated chamber and/or reduce contractility • Blood stagnation will result in thrombus formation Other cause • DCM - Post MI • Valve disease – MS • Prosthetis valve (mechanical/bio) • Arrhythmias ( Af,Flutter)

  14. CARDIAC MASS Morphology • Bright , well define, possible mobile mass, attach to cardiac wall or flat thickening in cardiac wall (mural) Echo Examination Usually clear, identifiable edges, the wall motion abnormal (akinetic/ dykanetic) • If left atrium common location at posterior near LAA • Amorphous ,echogenic structures with variable shape • May be multiple and mobile . • Pw doppler to assess flow velocity within LAA < 20cm/sec increase the embolic risk .

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  19. CARDIAC MASS Cardiac Tumor 2 type • Benign eq: myxoma , lymphoma, Fibroma • Malignant - primary – Common sarcoma Secondary – Metastase of other organ Lung Ca , Renal Ca - 80% cardiac Tumor - Benign Myxoma 80% of cardiac tumor . • Location • 75% - LA • 20% - RA • Rare at ventricle

  20. CARDIAC MASS LA Myxoma Role of echo examination -To look for : Size Extension/and Invasion within and outside the heart Valvular involment and competancy Ventricular function Pericardial effusion 2D All 4 Chamber should be visualized Location : Common origin from mid portion of the atrial septal atttach fosa ovale(narrow stalk) Shape : Polypoid ,pedunculated ,round or oval ,soft surface Size : Various Mobility : May prolapes during diastole Density : Echogenic and occasional calcified

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  23. CARDIAC MASS M-Mode Multiple echo line filling the space behind the mitral valve leaflet during diastole

  24. Doppler To detect any haemodynamic changes cause by obstruction of mitral flow

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  26. CARDIAC MASS Summary Echo examination gold standard to diagnose and manages patient with cardiac mass but other modality are needs to confirm the diagnosis such as : Contrast echo ,TEE, 3D ,MRI ,CT Scan ,Lab Ix , Clinical features .

  27. THANK YOU..

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