Cardiac metastases

Bussani, Rossana; De-Giorgio, Fabio; Abbate, Antonio; Silvestri, Furio

doi:10.1136/jcp.2005.035105

Cited by 585 publications

(693 citation statements)

References 27 publications

(18 reference statements)

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“…Consistent with our finding of varying CMET location, Bussani et al reported that among 662 patients with autopsy‐evidenced CMETs, lesions were dispersed throughout the pericardium (69%), epicardium (34%), myocardium (32%), and endocardium (5%)—although location of cardiac chamber involvement was not defined 14. Among 110 patents with autopsy‐proved CMET, Klatt and Heitz reported that lung carcinoma, breast carcinoma, melanoma, and lymphoma were the most common tumor etiologies, similar to data from other autopsy data reports 1, 15.…”

Section: Discussionsupporting

confidence: 89%

Pattern and Prognostic Implications of Cardiac Metastases Among Patients With Advanced Systemic Cancer Assessed With Cardiac Magnetic Resonance Imaging

Pun

Plodkowski

Matasar

et al. 2016

JAHA

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BackgroundCardiac magnetic resonance (CMR) imaging is well validated for tissue characterization of cardiac masses but has not been applied to study pattern and prognostic implications of cardiac metastases (CMETs) among patients with systemic cancer.Methods and ResultsThe population consisted of 60 patients with stage IV cancer (32 patients with CMETs, 28 diagnosis‐matched controls) undergoing CMR. CMET was defined as a discrete mass with vascular tissue properties on delayed enhancement CMR. CMET‐positive patients and controls had similar clinical characteristics, cardiac geometry, and function (P=NS). Leading cancer types associated with CMET were sarcoma, melanoma, and gastrointestinal. Patients with CMETs had similar distribution of extracardiac metastatic disease compared with controls (organs involved: 3.4±2.0 versus 2.7±1.9, P=0.17). In 94% of patients with CMETs, there were metastases involving ≥1 extracardiac organ (66% lung involvement). CMET location varied (right ventricle 44%, right atrium 19%, left ventricle 28%, left atrium 9%, pericardial 25%); 22% of cases had multichamber involvement. Right‐sided chamber involvement was common in hematologic/lymphatic spread (67%); pericardial involvement was common with direct spread (64%). Regarding tissue properties on delayed enhancement CMR, CMETs commonly (59%) demonstrated heterogeneous enhancement (41% diffuse enhancement). Heterogeneous lesions were larger and had increased border irregularity (P<0.05). Survival 6 months post‐CMR was numerically lower among patients with CMETs (56% [95% CI 39–74%]) versus stage IV cancer–matched controls (68% [95% CI 50–86%]), although differences between groups were nonsignificant (P=0.42).Conclusions CMETs vary regarding etiology, location, and tissue properties on CMR, highlighting need for comprehensive surveillance of cardiac involvement regardless of cancer origin. Prognosis remains poor with for patients with CMETs, albeit similar to that for stage IV cancer controls matched for cancer etiology.

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Section: Discussionsupporting

confidence: 89%

Pattern and Prognostic Implications of Cardiac Metastases Among Patients With Advanced Systemic Cancer Assessed With Cardiac Magnetic Resonance Imaging

Pun

Plodkowski

Matasar

et al. 2016

JAHA

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“…Although post-mortem studies would suggest that cardiac metastases occur frequently, many of these metastases remain clinically silent or unidentified due to overshadowing by symptoms of the primary malignancy [1]. However, secondary spread to the heart is important to recognize, as it occurs mainly in the context of disseminated disease and portends a poor prognosis [2], as illustrated by our case.…”

Section: Introductionmentioning

confidence: 77%

“…Based on data from postmortem studies of Bussani et al during the period from 1994 to 2003, the incidence of cardiac metastases involves 9.1% of early-stage cancers and 14.2% of metastatic. The most common sites of origin include the lung (pleural mesothelioma 48.4%, adenocarcinoma 21%, squamous-cell carcinoma 18.2%), skin (melanoma 27.8%), breast (15.5%) and undifferentiated carcinomas (19.5%) [1].…”

Section: Discussionmentioning

confidence: 99%

Intracardiac Metastasis from Epitheloid Sarcoma: Rare Localization and Difficult Management

Oualla¹,

Latifian²,

Georgala³

et al. 2014

CRCM

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The involvement of the heart in metastatic cancer is a very rare clinical diagnosis with poor prognosis given to the major risk of cardiac failure. They are frequently asymptomatic or symptoms, when present, may be attributed to other causes. The most common, among the latter, are intrathoracic cancers, lymphomas, leukemias, melanoma, and rarely sarcomas. The echocardiography is the gold standard for diagnosis, but scanner and magnetic resonance imaging (MRI) can be helpful for determination of exact location and composition of lesions. Cardiac metastases occur generally in advanced stage in poly-metastatic patients. Treatment is often in a palliative strategy but should be discussed in multidisciplinary approach for each case. We report a case of cardiac metastasis occurring in a 47 years old woman, treated for epitheloid sarcoma of the buttock. The aim of this work is to show the rarity of the heart location, describing the epidemiological, clinical, radiological, and prognostic features of these metastases and finally discussing the therapeutic strategy.

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“…Purulent pericarditis is present in a wide variety of pathological conditions with varying etiologies such as immunosuppression and chronic diseases (e.g., alcohol abuse, rheumatoid arthritis), but is commonly secondary to injury, cardiac procedures, or insult to the pericardium [1][2][3]. There is considerable urgency to establish a correct diagnosis, because if left untreated, the combination of tamponade and sepsis results in a mortality rate approaching 100% [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Bacterial pericarditis and antimicrobial resistance at the Tehran Heart Center, Iran

Anvari

Kianinejad

Boroumand

et al. 2015

J Infect Dev Ctries

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Introduction: When bacterial pericarditis is suspected, urgent pericardial drainage combined with intravenous antibacterial therapy is mandatory to avert devastating, life-threatening complications. There have been scanty results on antimicrobial susceptibility of common causative microorganisms of bacterial pericarditis; most studies had small sample sizes and were performed decades ago. Methodology: This prospective study surveyed the causative bacteria in infectious pericardial effusions and their antimicrobial susceptibility among 320 consecutive cardiac patients who underwent pericardiocentesis at Tehran Heart Center between 2007 and 2012, using the European Society of Cardiology (ESC)'s criteria. Results: Staphylococcus spp. (S. epidermidis, S. aureus, S. haemolyticus) were the main causative organisms isolated from cultures of pericardial effusion samples. Other causative organisms were Streptococcus spp., Enterococcus faecium, Pseudomonas aeruginosa, and Acinetobacter baumannii. In the cultures studied, 35% methicillin-resistant Staphylococcus epidermidis (MRSE) and 42.9% methicillinresistant Staphylococcus aureus (MRSA) were detected. The most effective antimicrobial agents in S. epidermidis were gentamicin, ciprofloxacin, and cefoxitin. Clindamycin was relatively effective. S. aureus was highly susceptible to clindamycin and erythromycin. In cases of S. haemolyticus infection, clindamycin, erythromycin, cefoxitin, and ciprofloxacin were effective antibiotics. Conclusions: In order to diminish the nascence and extension of antimicrobial-resistant pathogens, logical and optimized antimicrobial usage and monitoring in hospitals are highly recommended. It is incumbent on healthcare systems to determine current local resistance patterns by which to guide empiric antimicrobial therapy for specific infections and microorganism types.

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Cardiac metastases

Cited by 585 publications

References 27 publications

Pattern and Prognostic Implications of Cardiac Metastases Among Patients With Advanced Systemic Cancer Assessed With Cardiac Magnetic Resonance Imaging

Pattern and Prognostic Implications of Cardiac Metastases Among Patients With Advanced Systemic Cancer Assessed With Cardiac Magnetic Resonance Imaging

Intracardiac Metastasis from Epitheloid Sarcoma: Rare Localization and Difficult Management

Bacterial pericarditis and antimicrobial resistance at the Tehran Heart Center, Iran

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