title: Tumor blush: left ventricular cardiac hemangioma with supply from both the left anterior descending and circumflex arteries.
abstract: A fifty-year-old male had an echocardiogram for an abnormal electrocardiogram; it revealed a left ventricular mass. A cardiac catheterization revealed normal coronary arteries and a fine tumor blush of the cardiac tumor with feeding arteries from the circumflex as well as the second diagonal coronary vessels. Due to increased risk of embolization, he underwent surgery via a transatrial approach and a 1.5 cm cavernous-capillary hemangioma was removed from the base of the posteromedial papillary muscle. Primary tumors of the heart are rare, and the symptoms and signs depend on the location and size of the tumor. Coronary angiography remains an integral part in the evaluation of cardiac tumors and often can reveal a characteristic 'tumor blush.' The natural history of the tumor is unpredictable and excision of the tumor remains the treatment of choice. We present a rare case of characteristic angiographic tumor blush of a left ventricular cardiac hemangioma with feeding arteries from both the left anterior descending as well as the circumflex arteries. This rare two-system supply was due to the intracavitary location of the hemangioma, and fortunately did not pose any excessive difficulty in mobilization and excision during surgery.
authors.affiliation: Division of Cardiology, Albany Medical Center, Albany, New York, USA. avinklr@yahoo.com
authors.forename: Avinash
authors.initials: A
authors.lastname: Murthy
authors.forename: Ankit
authors.initials: A
authors.lastname: Jain
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Nappi
mesh_terms: D006328:Cardiac Catheterization; D013504:Cardiovascular Surgical Procedures; D017023:Coronary Angiography; D003326:Coronary Circulation; D003331:Coronary Vessels; D004452:Echocardiography; D006338:Heart Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000601:surgery; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006391:Hemangioma / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome