Myxoma undergone Resection and MVR

A cardiac papillary muscle tumor, also known as a cardiac papillary fibroelastoma, is a rare benign tumor that originates from the endocardium (inner lining) of the heart. These tumors typically arise from the papillary muscles, which are small muscle projections located within the ventricles of the heart. Cardiac papillary muscle tumors are usually small in size, measuring a few millimeters to a centimeter in diameter.

While the exact cause of these tumors is unknown, they are thought to develop from abnormal growth of connective tissue within the heart. They are generally considered benign, meaning they are non-cancerous and do not metastasize (spread) to other parts of the body. However, they can cause significant symptoms and complications due to their location and potential interference with normal heart function.

Symptoms of a cardiac papillary muscle tumor can vary depending on its size, location, and the extent of its effects on heart function. Common symptoms may include:

Chest pain: Tumors pressing against the heart or blood vessels may cause chest discomfort or pain.
Irregular heart rhythms: The presence of a tumor can disrupt the electrical conduction system of the heart, leading to abnormal heart rhythms (arrhythmias).
Murmurs: Tumors attached to the papillary muscles can cause abnormal blood flow through the heart valves, resulting in a heart murmur.
Fatigue and shortness of breath: Impaired heart function can lead to reduced cardiac output, causing fatigue and difficulty breathing with exertion.
Transient ischemic attacks (TIAs) or stroke: In rare cases, small fragments of the tumor may break off and travel through the bloodstream, potentially causing blockages in smaller blood vessels.
Diagnosis of a cardiac papillary muscle tumor typically involves a combination of medical history review, physical examination, and diagnostic tests. These tests may include:

Echocardiography: This ultrasound-based imaging technique provides detailed images of the heart, including the papillary muscles and any potential tumor.
Cardiac magnetic resonance imaging (MRI): An MRI scan can provide further visualization and characterization of the tumor.
Transesophageal echocardiography (TEE): In some cases, a TEE may be performed to obtain more detailed images of the heart structures, especially if the tumor is located in a less accessible area.
Electrocardiogram (ECG): This test records the electrical activity of the heart and can identify any abnormal heart rhythms.
Cardiac catheterization: In rare cases, a cardiac catheterization may be performed to assess the blood flow within the heart and obtain a biopsy sample of the tumor.
The treatment approach for cardiac papillary muscle tumors depends on various factors, including the size, location, symptoms, and overall health of the patient. Small asymptomatic tumors may be closely monitored without intervention, while larger tumors or those causing significant symptoms may require surgical removal.

Surgical options may include open-heart surgery or minimally invasive procedures such as robotic-assisted or video-assisted thoracoscopic surgery. The aim of surgery is to completely remove the tumor while preserving the function of the affected papillary muscle and maintaining normal heart function.

After the tumor is removed, long-term follow-up care is typically recommended to monitor for any recurrence or complications. Overall, the prognosis for patients with cardiac papillary muscle tumors is generally favorable, especially when the tumors are completely removed.

Dr.Sam Zeraatian Nejad Davani, CEO of rockingham medical research ADKWA center as well as Head of IUMS transplant and cardiovascular surgery department.