A 37-year-old man presented with a history of hemoptysis and associated fever, chills, night sweats, and weight loss. The patient had no other pertinent past medical history. Physical examination, CT scan, transesophageal echocardiogram, electrocardiogram, MRI scan, and immunohistochemical staining of tumor biopsy. Primary cardiac angiosarcoma of the right atrium with systemic metastases to the pericardium, superior vena cava, and lungs. Neoadjuvant and adjuvant chemotherapy with doxorubicin and complete surgical resection of the tumor with reconstruction of the right atrium using bovine pericardium.