often pedunculated. Surface is smooth, friable or villous. Internally may contain cysts and areas of necrosis and hemorrhage.

75 % – left atrium, 20 % – right atrium [6]. Tumors often arise at the interatrial septum at the border of fossa ovalis membrane [7].

emboli; symptoms of mitral valve obstruction, fever, weight loss, anemia, elevated CRP [8].

Carney complex – Autosomal Dominant; multiple tumors – myxomas (presenting earlier, sometimes multiple, more likely to recur), schwannomas, endocrine tumours, blue nevi, pigmented lentigines

LAMB – lentigines, atrial myxomas, mucocutaneous myxomas, blue nevi

NAME – nevi, atrial myxomas, myxoid neurofibomas, ephelides

Echo: Evaluate location, size, mobility, possible valvular obstruction

CT or MRI (increased intensity on T2 weighted images) – usually not needed. May help with location of attachment if not readily seen by echo.

surgical resection

Sporadic tumors – 3 %

Familial mycomas – 22 %

Recurrence frequency increases linearly for up to 4 years after which it decreases significantly

Site of recurrence is the same as original location of tumor in 81 % of cases

Follow up semiannually for 4 years after resection

Pedunculated, highly papillary, avascular tumour covered by a layer of endothelium. Tumors resemble sea anemones when placed in normal saline.

Most originate from the valves:

Aortic > Mitral > Tricuspid > Pulmonic.

Ninety-five percent in the left side of the heart [9].

Most patients are asymptomatic. Presentation may involve embolic events from both tumors (partial or whole) and thrombi attached to it (strokes, TIA, visual loss, angina, infarction, syncope, death), aortic or pulmonic stenosis symptoms.

Echo: small, mobile mass which is often pedunculated. Central echolucency may be present. Tumors often appear speckled and have stippled pattern near the edges (“shimmering edge”)

CT and MRI – usually not necessary.

large (≥1 cm) mobile and symptomatic tumours usually are resected [8, 9]. Some specialists recommend resection of tumors given potentially devastating consequenced of embolization. Consider observation and possible antiplatelet/anticoagulation therapy for others. Surgery is curative.

Accumulation of adipocytes

50 % subendocardial origin

More frequently located in the ventricles

usually asymptomatic

If present, are due to arrhythmias, heart block, compression of coronary arteries

Echo: helps with size and location

CT and MRI – may be useful for diagnosis since lipomas have distinctive fat imaging pattern

surgery if symptomatic

Microscopically consist of “spider cells” – striated cells with features of myocytes.

Tumors are usually multiple and located in ventricles [6].

arrhythmias, heart block, flow obstruction

Very strong association with tuberous sclerosis, ventricular pre-excitation and Wolff-Parkinson-White syndrome [8].

Echocardiography: round, usually well delineated echogenic masses which have a slightly higher intensity than surrounding myocardium [8, 12]. Echocardiography helps to evaluate location, size and significance of obstruction, if any.

CT – hypodense masses on contrast CT

MRI – T1 weighted images – isointense, T2 weighted images – hyperintense. MRI is useful for differentiation of rhabdomyoma from fibroma which is also common in children [3, 13].

observation (since there is often a spontaneous remission) and surgery in symptomatic patients