Cardiac Angiosarcoma as an Unexpected Cause of Palpitations: Case Report, Differential Diagnosis, and Current Therapeutic Approach to Cardiac Tumors.

We present a case of an 83-year-old woman who presented with palpitations, asthenia, and exertional dyspnea. The electrocardiogram showed atrial flutter, and echocardiography (UCG) revealed a large mass occupying the right atrial chamber. Contrast-enhanced computed tomography (CECT) and cardiac magnetic resonance (CMR) confirmed its origin and extension into the superior vena cava (SVC). A multidisciplinary medical committee considered palliative surgery as the best therapeutic option for the patient due to the impossibility of a complete surgical resection of the tumor. Primary malignant neoplasms of the heart are extremely rare. Their clinical behavior is aggressive, with high morbidity and mortality and frequent surgical limitations due to location and extent at diagnosis. Imaging techniques are essential for diagnosis such as UCG for initial detection, CMR for tissue characterization, and CT or positron emission tomography-computed tomography (PET-CT) for staging and therapeutic planning. Definitive diagnosis requires histologic study, although it is not free of significant complications. This is a case report of a rare cardiac tumor followed by review of literature on its diagnosis and therapeutic approach.