What are the other Names for this Condition? (Also known as/Synonyms)

• Cardiac Angioma
• Haemangioma of Heart
• Hemangioma of Heart

What is Cardiac Hemangioma? (Also known as/Synonyms)

• Hemangiomas are benign malformation of blood vessels that can occur in a number of tissues such as the kidney, liver, lung, skin, and brain
• Cardiac Hemangiomas are rare tumors that are observed in both children and adults. This type of hemangioma is generally a mix of capillary, cavernous, and arteriovenous (AV) hemangioma type
• There are no known risk factors for sporadic Cardiac Hemangiomas; however, in some individuals, the tumor is seen to be associated with Kasabach-Merritt syndrome (an uncommon disorder of the circulatory system seen in infants)
• Many small hemangiomas are often undiagnosed and do not cause any signs and symptoms. In some cases, Cardiac Hemangiomas may present with chest pain, breathing difficulties, arrhythmias, and pericardial effusion
• Complications could include heart failure, severe obstruction of heart function, and even sudden death due to severe arrhythmias
• Surgical removal of the hemangioma is typically the best treatment option for Cardiac Hemangioma. The prognosis of the tumor with suitable treatment (surgical excision and removal) is reported to be good

Who gets Cardiac Hemangioma? (Age and Sex Distribution)

• Cardiac Hemangiomas can occur in individuals of any age including children and adults
• Hemangiomas are seen to occur around the world, in individuals of any race, ethnicity, or gender. However, studies show a higher rate of occurrence in women
• Nearly 3% of all primary heart tumors are Cardiac Hemangiomas

What are the Risk Factors for Cardiac Hemangioma? (Predisposing Factors)

Risk factors associated with Cardiac Hemangioma include:

• Most cases of Cardiac Hemangiomas are sporadic in nature and occur randomly with no identified risk factor(s)
• Some are observed with Kasabach-Merritt syndrome; a rare and severe condition of the circulation system seen in young children

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Cardiac Hemangioma? (Etiology)

• Currently, the cause of Cardiac Hemangioma is not believed to be due to genetic factors
• Most tumors occur randomly and are termed sporadic; no cause is generally associated with sporadic hemangiomas

Rarely, there may be other hemangiomas observed outside the heart; i.e., they can be present in any organ of the body. Hemangiomas, in general, may be seen in association with many genetic disorders including von Hippel Lindau syndrome, Roberts syndrome, Klippel-Trenaunay-Weber syndrome, and many others.

In such cases, the hemangiomas may be caused by certain genetic mutations. Hemangiomas associated with genetic disorders are called syndromic hemangiomas.

What are the Signs and Symptoms of Cardiac Hemangioma?

Hemangiomas of Heart are typically solitary tumors, unless they are seen in association with other genetic syndromes. The tumor is well-defined or poorly-defined based on the hemangioma type (whether capillary, cavernous, or AV type). Small tumors may not present any significant signs and symptoms.

The signs and symptoms are dependent upon the location of the tumors in the heart, and may include:

• Breathing difficulty on slight physical exertion
• Chest pain
• Arrhythmia (irregular heartbeat), which may be due to both small or large tumors
• Heart failure (on the right side usually)
• Fluid buildup in the heart (pericardial effusion)
• Swollen pericardium (membrane covering the heart)
• Over 60% of the time, the hemangioma is found in the right or left ventricle; sometimes, on the blood flow tract
• Most tumors are known to grow to large sizes
• Some Cardiac Hemangiomas may resemble AV malformations

How is Cardiac Hemangioma Diagnosed?

A diagnosis for Cardiac Hemangioma may include evaluating the clinical history (physical exam) and a thorough family history. Other tools to help diagnose the condition may include:

• Electrocardiogram (EKG): It is used to measure the electrical activity of the heart, in case of arrhythmias
• MRI scan of the heart
• CT scans (generally for larger hemangiomas) with a contrast agent
• Echocardiography to assess the heart movement
• Electron microscopy study
• Doppler ultrasound: Sound waves are used to measure the speed and direction of blood flow
• Angiographic studies of the heart
• Electrophysiological studies
• Cardiac catheterization studies
• Tissue biopsy of the hemangioma

Note: Most tumors are discovered incidentally, while a medical exam is being performed for other health conditions.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Cardiac Hemangioma?

Complications associated with Cardiac Hemangiomas may include:

• Large tumors can block the flow of blood in the heart causing heart dysfunction
• Large tumors can also cause thrombosis and clotting difficulties (when seen with Kasabach-Merritt syndrome)
• Severe arrhythmias
• Heart failure
• Sudden death
• Individuals who undergo treatment may be at risk for surgical complications
• Complications due to underlying disorders, if any

How is Cardiac Hemangioma Treated?

The treatment of Cardiac Hemangioma may involve the following measures:

• The healthcare provider may chose to closely monitor small tumors that present no signs and symptoms
• Anti-arrhythmic medication can be administered, in case of arrhythmias
• Hemangiomas causing significant signs and symptoms may need to be surgically removed
• Arterial embolization of Cardiac Hemangioma is a possible treatment option. Here the blood supply to the tumor is blocked, resulting in tumor death
• Treatment of underlying vascular disorders such as Kasabach-Merritt syndrome
• Observation and periodic checkups to monitor the condition is important and is recommended

How can Cardiac Hemangioma be Prevented?

Currently, there are no specific methods or preventative techniques for Cardiac Hemangiomas.

What is the Prognosis of Cardiac Hemangioma? (Outcomes/Resolutions)

• The prognosis of Cardiac Hemangioma depends upon the location, size, and underlying signs and symptoms of the tumor
• With complete excision and removal of the tumor, the prognosis is generally good

Additional and Relevant Useful Information for Cardiac Hemangioma:

• Kasabach-Merritt syndrome (KMS) is a rare, life-threatening condition affecting the ability of blood to clot, which is observed in newborns and infants

The following DoveMed website link is helpful in understanding Kasabach-Merritt syndrome:

http://www.dovemed.com/diseases-conditions/kasabach-merritt-syndrome/