Primary Cardiac Angiosarcoma Presenting with Pericardial Effusion and Cardiogenic Shock Two Cases Report

Primary tumors of the heart occur with an incidence rate of 0.001% to 0.28%. Sarcomas comprise the largest proportion of primary malignant cardiac tumors. Angiosarcoma is the most common malignant tumor of the heart. This tumor is found most often in the right atrium and frequently extends to the pericardium, vena cava, or tricuspid valve, causing tamponade and/or heart inflow obstruction. We present 2 cases of angiosarcoma with cardiogenic shock due to massive pericardial effusion and obstruction to blood flow in the tricuspid valve area. After having resection of the original tumors, 1 patient needed to have pacemaker implantation due to sinus node dysfunction with junctional bradycardia, while the other patient had recurrent cardiac tumor and lung metastases. Despite diagnosis by noninvasive imaging procedures and aggressive early surgical intervention, survival in both cases was less than few months. Thus, optimal therapy is unclear.