Primary tumours of the heart

Abstract

<h2>Summary</h2> A brief description of certain features of primary heart tumours is given, based on the more recent literature. About five hundred primary heart tumours had been described up to 1957, of which 35 per cent are myxomas, a tumour which often presents as mitral stenosis. Malignant tumours comprise 20 per cent of the total, and mainly arise on the right side of the heart. Some features of the mechanism whereby tumours exert their effects, especially in regard to the blocking of valves and pulmonary veins, is discussed. A systemic reaction in some myxomas which may consist of fever, anaemia, leucocytosis, raised E.S.R., and possibly hyperglobulinaemia is confirmed, and a similar type of reaction is noted in some malignant tumours. A classification of the radiological features is made. A large number of primary heart tumours are indistinguishable from common heart conditions, and only a minority present as an unusually pulsating prominence, but some myxomas exert pressure on the oseophagus in this manner. Angiocardiography is the most accurate method of demonstration. A sarcoma and a myxoma in adults are described the latter showing most features of the systemic reaction, including hyperglobulinaemia. A fibroma, a rhabdomyoma and a myxoma in infants are described. Two of these were interpreted as being due to congenital heart disease, the myxoma occurring in the tricuspid valve of a Mongol, and the fibroma being associated with congenital deformity of the spine. The importance of diagnosis in the early stages is emphasised in view of the increasing success of the removal by heart surgery. Inexplicable, non-correlating features or an abnormal variability may provide the clue to the diagnosis, but the evidence may be very slight indeed, and careful history taking, especially in relation to the effects of posture, is stressed.