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We provide our users the most up-to-date and accurate information on the treatment and prevention of cardio pathologies in accordance with current American and European clinical guidelines.
The information provided on this website is for educational purposes only and should not be considered medical advice. Always consult a licensed physician for diagnosis and treatment.
Papillary Fibroelastoma
Introduction
Papillary fibroelastoma (PFE) is a rare, benign cardiac tumor that primarily affects the heart valves. Despite its non-cancerous nature, it can have serious clinical consequences due to its potential to cause embolic events.
Causes and Risk Factors
The exact cause of PFE is unknown. However, it is thought to result from: - Endothelial damage leading to an overgrowth of fibroelastic tissue. - Aging – it is more common in older adults. - Previous cardiac surgery or inflammatory processes may also play a role.
Symptoms
PFE is often asymptomatic and discovered incidentally. However, when symptoms occur, they are usually due to embolization and may include: - Stroke or transient ischemic attack (TIA). - Coronary embolism, which can mimic a heart attack. - Valvular dysfunction, leading to heart murmurs or heart failure symptoms. - Sudden cardiac death (rare).
Diagnosis
PFE is typically diagnosed through imaging studies such as: - Echocardiography (Transthoracic or Transesophageal) – the gold standard for visualizing the tumor. - Cardiac MRI or CT scan – used for further structural assessment.
Treatment
Treatment depends on the size, location, and symptoms: - Asymptomatic small PFE: Regular monitoring with echocardiography. - Symptomatic or large PFE: Surgical removal (valve-sparing resection if possible) to prevent embolic complications. - Anticoagulation therapy may be considered in patients at high risk of embolization who cannot undergo surgery.
Prognosis
After surgical excision, the prognosis is excellent, with a very low recurrence rate. Regular follow-up is advised to monitor for possible complications.
Conclusion
PFE, though benign, should not be ignored due to its potential for serious complications. Early diagnosis and appropriate management can prevent life-threatening outcomes.
Source recommendations
1. American Heart Association Guidelines on Management of Cardiac Tumors
- https://www.ahajournals.org/doi/10.1161/JAHA.120.016032
- https://www.heart.org/
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000000679
- https://www.heart.org/en/news/2019/02/25/the-heart-isnt-particularly-vulnerable-to-cancer-and-heres-why
- https://professional.heart.org/en/
2. European Society of Cardiology Guidelines on Cardiac Masses
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Cardio-oncology-guidelines
- https://www.jacc.org/doi/abs/10.1016/j.jaccao.2020.05.009
- https://www.escardio.org/static-file/Escardio/Education-Subspecialty/Courses/EACVI/EACVI%20preparatory%20course%20to%20cerfication%20in%20CMR/Cardiac%20masses%20and%20tumors_C.%20Bucciarelli-Ducci_on_behalf_of_L.Natale%20.pdf
- https://academic.oup.com/ehjcimaging/article/24/12/1605/7256773
- https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-4/vol4n17-Title-MRI-for-the-diagnosis-of-cardiac-tumors
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If you or your loved ones experience any of these symptoms, you should consult a doctor in time. Remember that self-medication can be dangerous, and timely diagnosis will preserve the quality and life expectancy.
The heart is an organ that does not know how to "keep silent" if something goes wrong. Chest pain, shortness of breath, swelling, dizziness, and rhythm disturbances are the symptoms that require our attention. The best prevention of heart disease is careful attention to your health, regular checkups with a doctor, and a healthy lifestyle. Take care of your heart, and it will serve you for many years!
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