Right Atrial Angiosarcoma Presenting With Cardiac Tamponade, Hemorrhagic Pericardial Effusion, and Pulmonary Embolism: A Case Report

TL;DR

A rare case of right atrial angiosarcoma presented with severe heart and lung complications, requiring urgent surgery and chemotherapy.

Contribution

This case report presents an unusual clinical presentation and management approach for primary cardiac angiosarcoma.

Findings

The patient had severe pericardial effusion, cardiac tamponade, and pulmonary embolism due to a right atrial angiosarcoma.

Surgical excision and pericardial window creation were performed, with histopathology confirming angiosarcoma infiltration.

The case emphasizes the importance of timely diagnosis and multidisciplinary management in aggressive cardiac tumors.

Abstract

Primary cardiac angiosarcoma is a rare and aggressive malignancy most commonly arising from the right atrium. We report a 43-year-old male patient who had no known comorbidities and was not receiving any regular medications. He presented with abdominal and epigastric pain and was found to have severe pericardial effusion, cardiac tamponade, a large right atrial mass, hemorrhagic pericardial effusion, and bilateral pulmonary emboli. He underwent urgent pericardiocentesis followed by open-heart surgery for excision of the right atrial mass, pericardial window creation, and mediastinal lymph node biopsy. Histopathology confirmed angiosarcoma infiltrating the right atrium, pericardium, and associated thrombus. Postoperative recovery was uneventful, and oncology recommended systemic chemotherapy. This case highlights atypical presentations of cardiac angiosarcoma and outlines the surgical and diagnostic approach.

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