ABSTRACT
The finding of a cardiac mass often has significant clinical implications and therefore apparent masses need careful echo evaluation to determine, as far as possible, their likely nature. Myxoma is the commonest primary cardiac tumour, accounting for 50 per cent of cases, and is commoner in women. Myxomas are attached to the heart by a pedunculated stalk – in the case of atrial myxomas, they attach to the interatrial septum at the fossa ovalis. The echo appearances of a myxoma are of a well-defined mass, which is often mobile, and the pedicle may be visible. Surgical resection of the myxoma is the treatment of choice. The tumours can be a source of thrombotic emboli, or fragments of the fibroelastoma itself can embolize, and surgical resection should therefore be considered, particularly if they are large, mobile and present in the left heart. Malignant tumours make up 25 per cent of primary cardiac tumours and the vast majority are sarcomas.
