Primary Cardiac Angiosarcoma: Authors' Perspective Following Synthesis of Available Literature

Abstract

Why are malignant primary cardiac tumors so rare? Is it because of the specialized cardiac muscle cells or the large number of mitochondria per cell? Is it because cardiac muscle is the most aerobic organ of the body and its myocardial capillary density is at a 1:1 ratio, which is 10-fold higher than that of the skeletal muscle? There is overwhelming evidence regarding the benefits of aerobic exercise in prevention of many types of cancer and their associated sequelae. However, there appears to be an evidence gap that needs to be filled. Is there a link between the rare occurrence of primary cardiac cancers in terms of the oxygenation of cardiac muscle tissue and the benefits of aerobic exercise that could provide a new area of research for the primary prevention of cancer? Discussion of these questions was the impetus for the authors to conduct a literature search and then synthesize the review findings. This perspective aims to explore currently available knowledge and gaps in available evidence to understand areas in which physical therapists may impact the varied levels of preventive intervention on primary malignant cardiac cancers. The 35 presenting symptoms and medical history reported in the literature may provide a basis for correlation with other genetic and epigenetic factors to explore along our journey for answers. The physical therapy profession is well positioned to promote healthy behaviors and provide patient education to reduce risk factors and prevent and treat noncommunicable diseases consistent with a biopsychosocial paradigm.