A lady with excertional dyspnoea due to cardiac metastases

Abstract

Contrary to primary malignant cardiac tumors, metastatic tumors of the heart are relatively common. Cardiac metastases are usually the immediate cause of death in about one-third of such cases. They may cause cardiac failure, pericardial effusion and arrhythmia, with cardiac failure being the most common cause of death as a result of restrictive ventricular inflow and outflow tract obstruction, myocardial disease and pericardial constrictive disease. According to autopsy reports, cardiac metastases have been found in about 25% of patients with soft-tissue sarcoma. The incidence of cardiac metastasis has increased during recent years in view of better diagnostic tools and aggressive treatment of malignant tumors have led to longer survival of patients. Despite their increasing frequency, cardiac metastases are rarely diagnosed in living patients because other metastatic symptoms co-exist. We report a case of relapsed malignant peripheral nerve sheath tumor with symptomatic metastases to the heart. She was planned for surgery but in view of poor general condition, she was managed with palliative chemotherapy.