Release date: 2017-06-28
Often asked by people, you see who has lung cancer, or breast cancer, gastrointestinal cancer, thyroid cancer, etc., who has never heard of a heart tumor. Why is the heart not growing cancer?
Indeed, unlike other organs and tissues, human cardiomyocytes do not divide and multiply after birth. Cardiomyocytes are called “terminally differentiated cellsâ€, that is, the lifespan of such cells is the same as human beings. After birth, it no longer divides and proliferates, its quantity remains unchanged, it is highly differentiated, and it has only certain functions. The genes involved in division and proliferation cannot be expressed, so it is difficult for cardiomyocytes to develop primary cancer. At the same time, the blood flow in the heart is extremely fast. It is also difficult for other cancer cells to fall into the blood to deposit cancer on the heart, because the transfer of cancer cells requires not only the easy fallout of cancer cells, but also the need for cancer cells to be in the body. The local area is under the development of the camp. Although there are nervous system, fat, mesothelium and other tissues in the heart, the blood flow in the heart is too fast. Most cancer cells have no chance to rest their feet and they are brought out of the heart by the blood. . Therefore, the heart is also a rare area for metastasis.
What tumors may the heart itself grow?
However, rare is rare, the heart can still grow tumors.
Cardiac myxoma
Cardiac myxoma is the most common benign tumor of the heart. Nearly 75% of atrial myxoma is confined to the left atrium and interatrial septum. In general, cardiac myxoma often has a "pedicle". Ultrasound can be seen that this "pedicle" suspends the myxoma on the atrial side. When the heart is dilated, the myxoma can be prolapsed through the mitral valve to the left ventricle. Myxoma is more common in women aged 30-60 years. 90% of patients may have systemic symptoms such as weight loss, fever, anemia, elevated erythrocyte sedimentation rate, and elevated levels of immunoglobulins (usually IgG).
Arterial embolism can occur in 50% of patients, involving the brain (50% of embolism), heart, kidney, limb extremities, and aortic branches. Especially when young people have embolism and heart rhythm is sinus rhythm, they should be highly alert to cardiac myxoma. Left atrial myxoma, mitral or pulmonary venous obstruction, secondary right heart failure due to pulmonary vein or pulmonary hypertension. Symptoms of left atrial myxoma include difficulty breathing, sitting breathing, and symptoms of acute pulmonary edema, hemoptysis, dizziness, and syncope. Occasionally, sudden death can occur. Changes in the patient's position may also produce symptoms. Once confirmed, surgical myxomatosis should be performed.
Primary cardiac malignancy
Almost all primary cardiac malignancies are sarcomas - the most common angiosarcoma, often originating in the right atrium or pericardium. 25% of angiosarcomas can cause valvular obstruction, right heart failure, and hemorrhagic pericardial effusion leading to pericardial tamponade. Surgical removal of tumors, radiotherapy, and chemotherapy can alleviate some symptoms.
Pericardial tumor
Because 75% of pericardial cysts are asymptomatic, they are often found when they are examined by chance. Cysts are mostly located in the right heart angle, and echocardiography and CT examination can identify pericardial cysts and solid tumors. Mesothelioma, a pericardial malignancy, may present severe conditions including pericarditis, restrictive pericardial disease, and inferior vena cava obstruction. Histological examination of pericardial effusion is often helpful in diagnosis. The prognosis of mesothelioma is poor. Roughly resected mesothelioma by surgery, radiotherapy and chemotherapy can only temporarily relieve symptoms.
Other benign tumors of the heart
Rhabdomyosarcoma, the most common cardiac tumor in children, occurs in the myocardium, often accompanied by hardening nodules, which can cause arrhythmias and obstructive symptoms.
Fibroids can cause sudden death. Like lipomas, fibroids can grow to a large extent.
What are the tumors that are transferred to the heart?
The metastatic tumor of the heart or pericardium is 20-40 times more than the primary tumor. The way tumors invade the heart involves direct invasion of adjacent organs or invasion through the vena cava and pulmonary veins. There are two ways of metastasis of metastatic tumors: blood or lymph. The incidence of cardiac metastatic malignancies accounts for 2-20% of malignant tumors; lung cancer and breast cancer are the most common tumor sources of metastatic cardiac tumors. Patients with leukemia and lymphoma may also have heart involvement, and cardiac involvement may also occur in patients with AIDS who develop Kaposi's sarcoma.
Secondary cardiac tumors can involve the pericardium, myocardium, endocardium, valve, or coronary artery. Pericardial involvement can cause pleural pain and pericardial friction. Significant heart enlargement, pericardial tamponade, and decreased QRS amplitude of the ECG can occur. Both echocardiography and CT examination can indicate pericardial effusion and contribute to the localization diagnosis of intracardiac or pericardial tumors. The electrocardiogram of the pericardium is characterized by ST and T wave changes, often with arrhythmia, or even complete heart block. A wide range of myocardial involvement can produce heart failure. Radiotherapy and chemotherapy can also cause heart damage and heart failure. Tumor embolism, external pressure and radiotherapy can cause coronary artery involvement. When the primary tumor (such as renal cell tumor, liver cancer or uterine leiomyosarcoma) spreads to cause secondary tumor of the heart, any kind of cancer cells can enter the right atrium along the inferior vena cava, and the lung tumor can also spread to the left. Atrium. MRI and CT can provide information on anatomy and tumor origin and extent. There have been reports of successful surgical removal of cardiac tumors.
What if you suspect that your heart has a tumor?
When clinically suspected cardiac metastases, further examination is needed to confirm the diagnosis. Patients with dyscrasia may have problems with heart enlargement, arrhythmia, chest pain or congestive heart failure and the possibility of cardiac metastases. Two-dimensional transthoracic and transesophageal echocardiography, CT and MRI can provide more diagnostic information. Cytological examination of the pericardial effusion and endocardial biopsy provide a basis for histological diagnosis.
Depending on the type of cardiac tumor cells, radiation therapy can be chosen and chemotherapy is needed. Pericardial effusion requires urgent pericardial puncture during pericardial tamponade, or pericardial drainage. Some drugs can also be injected into the pericardium to treat malignant pericardial effusion, such as fluorouracil, nitrogen mustard and tetracycline. If the pericardial effusion continues to increase, surgical incision may be required and the pericardial window may be left in place. Non-surgical treatment options include percutaneous balloon catheter pericardial-pleural drainage. Surgical removal of secondary tumors in the heart cavity that cause obstructive symptoms may improve symptoms and prolong life.
Source: Popular Science China Public Number
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