title: Cardiac angiosarcoma with cardiac tamponade diagnosed as a ruptured aneurysm of the sinus valsalva.
abstract: Primary cardiac angiosarcoma is a rare, diagnostically elusive disease with a poor prognosis. In this report, we describe the case of a 56-year-old woman with a right atrial angiosarcoma. The patient presented with impending cardiac tamponade caused by right atrial perforation, but was misdiagnosed as a ruptured aneurysm of the sinus valsalva based on findings of a continuous murmur and an aorta to right atrium shunt by echocardiography. In the emergent operation that ensued, we found a right atrial perforation and a right coronary artery fistula to the right atrium. Coronary artery fistula is a rare complication of primary cardiac angiosarcoma, and a continuous murmur is also extremely rare as a clinical finding of angiosarcoma. We report the case and review the literature.
authors.affiliation: Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan. iyoshing@yahoo.co.jp
authors.forename: Isamu
authors.initials: I
authors.lastname: Yoshitake
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Hata
authors.forename: Akira
authors.initials: A
authors.lastname: Sezai
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Niino
authors.forename: Satoshi
authors.initials: S
authors.lastname: Unosawa
authors.forename: Kazuma
authors.initials: K
authors.lastname: Shimura
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kasamaki
authors.forename: Kazutomo
authors.initials: K
authors.lastname: Minami
mesh_terms: D017542:Aneurysm, Ruptured / Q000175:diagnosis* / Q000601:surgery; D001014:Aortic Aneurysm / Q000175:diagnosis* / Q000601:surgery; D002305:Cardiac Tamponade / Q000175:diagnosis* / Q000601:surgery; D004452:Echocardiography; D005260:Female; D006337:Heart Murmurs / Q000175:diagnosis; D006338:Heart Neoplasms / Q000175:diagnosis* / Q000601:surgery; D006394:Hemangiosarcoma / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D012850:Sinus of Valsalva / Q000473:pathology* / Q000601:surgery