Syncope in a Patient With Spindle Cell Sarcoma of the Main Pulmonary Artery
A 44-year-old man was hospitalized after a syncopal episode. A thrill and loud systolic ejection murmur were present over the left border of the sternum. A 12-lead ECG and chest x-rays were normal. A 2D echocardiogram and Doppler studies documented normal cardiac chambers and a peak systolic pulmonary transvalvular gradient of 80 mm Hg. Biplane right ventriculography revealed a large mobile mass in the main pulmonary artery extending into the right ventricular outflow tract (Figure 1⇓). Cardiac MRI showed the mass within the same area (Figure 2⇓ and Figure⇓ I, which can be found at www.circulationaha.org). The patient underwent surgical resection of a large tumor in the main pulmonary artery (Figure 3⇓). The tumor extended into the right pulmonary artery. The pulmonary valve was replaced with a homograft, and an endarterectomy of the main and right pulmonary arteries was accomplished. Histological examination revealed a spindle cell sarcoma (Figures 4⇓ and 5⇓). The patient remained asymptomatic and had no cardiac murmurs 8 months after surgery.1
Figure⇓ I is a cine image and can be found Online at www.circulationaha.org.
- Copyright © 2001 by American Heart Association