Pericardium: hemangiosarcoma

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Sections available in full article Introduction, Presenting signs, Acute presentation, Age predisposition, Breed predisposition, Cost considerations, Special risks (e.g. anesthetic), Pathogenesis, Etiology, Predisposing factors, Pathophysiology, Timecourse (incubation, duration), Diagnosis, Presenting problems, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Gross autopsy findings, Differential diagnosis, Treatment, Initial symptomatic treatment, Standard treatment, Monitoring, Subsequent management, Sequelae, Prognosis, Expected response to treatment, Sources, Publications, Vetstream contributor(s),
Contributors Dr Serena Brownlie BVM&S PhD CertSAC MRCVS
Mr Mark Rishniw BVSc MS DipACVIM

Introduction

  • May affect right atrium, right atrioventricular junction or right ventricle alone or other sites (spleen, etc).
  • Vascular tumor - often ruptures and bleeds into pericardial space.
  • Sudden build-up of pericardial blood leads to increased pericardial pressure, which compromises atrial and ventricular filling.
  • Signs : collapse, output failure. Ventricular or supraventricular dysrhythmias.

Diagnosis

Clinical signs

  • Same as pericardial effusions Pericardial disease.
  • Dysrhythmia (often ventricular).
  • Heart sounds markedly muffled.
  • Pulsus paradoxus (peripheral pulse that waxes and wanes with respiration) can sometimes be appreciated.
  • Thready pulse.
  • Tachycardia and tachypnea.
  • Pale mucous membranes, due to low-output failure.

Diagnosis

Differential diagnosis

  • Idiopathic pericardial hemorrhage Pericardium: idiopathic hemorrhage.
  • Pericardial mesothelioma Mesothelioma.
  • Chemodectoma Pericardium: neoplasia (heartbase tumor).
  • Other neoplastic pericardial effusions (lymphoma).
  • Infectious pericarditis.

Sequelae

Prognosis

  • Poor: all measures are palliative → death usually within 10-30 days if no specific therapy. Can be substantially longer if surgical/chemotherapeutic option is elected (5-6 months).

Expected response to treatment

  • Quality of life.
  • Condition relentlessly progresses; warrants euthanasia, or animal may die.

Sources

Publications

Refereed papers

  • Recent references from PubMed.
  • Weisse C, Soares N, Beal M W, Steffey M A, Drobatz K J & Henry C J (2005) Survival times in dogs with right atrial hemangiosarcoma treated by menas of surgical resection with or without adjuvant chemotherapy: 23 cases (1986-2000). JAVMA 226 (4), 575-579 PubMed.
  • Shaw S P, Rozanski E A & Rush J E (2004) Cardiac troponins I and T in dogs with pericardial effusion. J Vet Intern Med 18 (3), 322-324 PubMed.
  • Fine D M, Tobias A H & Jacob K A (2003) Use of pericardial fluid pH to distinguish between idiopathic and neoplastic effusions. J Vet Intern Med 17 (4), 525-529 PubMed.
  • Bussadori C, Grasso A & Santilli R A (1998) Percutaneous pericardiotomy with balloon catheter in the treatment of malignant pericardial effusion in dogs. Radiol Med 96 (5), 503-506.
  • Cobb M A, Boswood A, Griffin G M & McEvoy E J (1996) Percutaneous balloon pericardiotomy for the management of malignant pericardial effusion in two dogs. JSAP 37 (11), 549-551 PubMed.
  • Cobb M A & Brownlie S E (1992) Intrapericardial neoplasia in 14 dogs. (1992) JSAP 33 , 309-316.
  • Aronsohn A (1985) Cardiac hemangiosarcoma in the dog - a review of 38 cases. JAVMA 187 , 922-926.

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