Sometimes, we can have problems inside our bodies that we don't even think about, right? Maybe you're seeing a doctor for something else, or maybe you're doing an emergency test, and you find out that there's something small in your heart, maybe a small tumor. When you hear the word 'heart tumor', your heart immediately jumps and you feel scared. But you have to remember that not all tumors are cancerous . Today, we're going to talk about a type of tumor that develops in the heart, but is not cancerous, but needs some attention. Doctors call this a papillary fibroelastoma . Although the name may seem a bit long, let's talk about it simply.
What is Papillary Fibroelastoma?
Simply put, this papillary fibroelastoma is a non-cancerous (benign) tumor that occurs in the heart. This means that it is not cancer and does not spread to other parts of the body. These are also called primary heart tumors because they start in the heart itself. They do not come to the heart from somewhere else.
However, even though it is not cancer, it is not completely safe. Because, this tumor can become embolic. Embolic means, imagine, a small piece of this tumor can break off and travel with the blood, getting stuck in a blood vessel somewhere else in the body. If that happens, there is a possibility of serious complications like a stroke .
Most of the time, about eight out of ten, papillary fibroelastomas develop on the heart valves. In fact, they are the most common type of tumor that develops around the heart valves.
Which heart valves are most likely to develop these?
These tumors are usually found on the valves on the left side of the heart. That is, on the aortic valve (the most common) or the mitral valve . Rarely, they form on the tricuspid valve or pulmonary valve on the right side of the heart.
The good news is that papillary fibroelastomas usually do not cause significant disruption to the function of heart valves. This is because these tumors are located on the downstream side of the valve, meaning the side where blood flows past the valve.
This is why these tumors are different from another type of heart tumor called cardiac myxoma . Myxomas are usually larger and more likely to interfere with the function of the valves than papillary fibroelastomas. Another thing is that myxomas are less likely to be attached to the valves, unlike papillary fibroelastomas.
Where exactly in the heart is this nut?
As we mentioned earlier, these tumors are most commonly found on the valves of the heart. About 95 percent (95%) of them are on the left side of the heart. Very rarely, they develop on the inner wall of the heart chambers, especially the left ventricle.
How does papillary fibroelastoma affect the body?
This is the most important thing to pay attention to. Papillary fibroelastoma can cause blood clots to form and travel through the bloodstream. Blood clots that travel in this way are called emboli . These emboli can travel to various parts of the body and get stuck. For example:
- Brain: If this happens , a stroke can occur.
- Coronary arteries: This can cause a heart attack .
- Kidneys
- Lungs
- Retinas of the eyes
- Spinal cord
Because of this blood clotting and blockage,
- Heart attack
- Stroke
- Things like ventricular fibrillation (a serious condition in which the heart beats irregularly and rapidly) can occur.
Additionally, if the tumor is located on the aortic valve, it can block the coronary arteries that supply blood to the heart. This can cause angina , a chest pain that occurs when the heart does not get enough blood, during exercise. There is also a risk of sudden cardiac death .
Who is affected the most by this situation?
Papillary fibroelastomas are usually seen in adults over the age of 40. Most often, the disease is diagnosed around the age of 60. Very rarely, these tumors can also develop in babies and young children with congenital heart defects .
How common is papillary fibroelastoma?
Primary heart tumors, which start in the heart, are actually very rare. They affect less than one in 2,000 people. Of these primary heart tumors, the two most common non-cancerous types are papillary fibroelastoma and cardiac myxoma. But it's hard to say exactly how common they are, because they're often discovered post-mortem after someone has died.
What are the symptoms?
Surprisingly, more than half of people with this condition do not show any symptoms. Those who do have symptoms may experience things like:
- Angina: Chest pain or discomfort.
- Syncope: Loss of consciousness.
- Shortness of breath.
- Transient Ischemic Attack (TIA) or Stroke: A TIA is a temporary decrease in blood flow to the brain, similar to a mini-stroke, with symptoms that disappear within a few minutes.
What is the reason for this?
The exact cause of papillary fibroelastomas is not yet known. However, many scientists believe that they are caused by damage to the endothelial cells that line the inside of the heart. It is thought that small blood clots collect, travel to the site of damage, and gradually form a tumor-like mass.
How do you diagnose this?
Most of the time, papillary fibroelastoma is discovered incidentally. That is, the doctor finds the tumor during a test you're doing for another reason. Or, it may be discovered when someone has a stroke and is trying to figure out the cause.
The main test to diagnose this is echocardiography . This is a scan of the heart.
- First, doctors usually do a transthoracic echo , which means it's done on the surface of the chest.
- But sometimes, to check for very small tumors or to get a clearer look at the affected area , a transesophageal echo (TEE) may be done. This involves inserting a small camera-equipped tube through the esophagus to examine the heart.
How does this tumor appear on the Echo?
On an echocardiogram, this papillary fibroelastoma looks like a sea anemone! That's because it has tiny branch-like structures called papillary fronds that extend from its surface.
This fruit is usually small (less than 1 cm). Also, it is pedunculated by a stalk/stem . This stalk allows the fruit to move around well, that is, it is mobile .
What is the treatment?
The usual treatment for papillary fibroelastoma is surgery. During surgery, the surgeon:
- The entire tumor is removed.
- They examine other parts of the heart to see if there are any more tumors.
- If the tumor has damaged any part of the heart, it will also be repaired. This may include valve repair or valve replacement.
The important thing is, even if you don't have symptoms, your doctor may recommend surgery to minimize future complications.
The surgery is often done using traditional open-heart methods . However, some people may also use minimally invasive robotic methods . Talk to your doctor to decide which method is best for you.
Similarly , if surgery is too risky for you, your doctor may decide to prescribe anticoagulants, or blood thinners , to reduce the risk of blood clots.
How is the condition after treatment? (Prognosis)
The prognosis for people who have had surgery to remove a papillary fibroelastoma is very good. The risk of the tumor coming back is very low. Also, since it is not cancerous, there is no risk of it spreading to other parts of the body.
When should I see the doctor?
These types of tumors in the heart are often discovered by chance. That's why it's important to keep all your medical appointments and follow-ups. Early detection of tumors is easier to treat. If left untreated, papillary fibroelastomas can grow and cause serious complications.
If you have open-heart surgery to remove a tumor, your body will need time to heal. Talk to your doctor about what not to do and what activity restrictions you should follow for a few weeks after surgery. You may also be referred to a cardiac rehab program to help you regain your strength.
What questions should I ask the doctor?
If you are diagnosed with papillary fibroelastoma, ask your doctor these questions:
- How big is the tumor?
- Where is it?
- How does it affect my heart?
- Do I need surgery? If so, how soon?
- How do I prepare for the surgery?
- How is the recovery time?
- What are the risks of surgery?
- How will my condition be after treatment?
- How long will it be before I have to come back for tests?
What does a heart mass mean?
A mass on your heart is any abnormal growth (tumor) in the heart. Doctors call these cardiac tumors . These heart tumors can be cancerous or noncancerous. They can also start in the heart (primary) or spread to the heart from somewhere else in the body (metastatic).
It's very rare for a tumor to start in the heart itself. But of the tumors that do, papillary fibroelastoma is the most common type, along with cardiac myxoma.
It's normal to feel scared when you're told you have a heart tumor. But the good news is that papillary fibroelastoma is not cancerous, doesn't spread to other parts of the body, and is often curable with surgery. Talk to your doctor about the best treatment plan for you and what to expect going forward.
The most important things to remember (Take-Home Message)
You may now have some understanding of the Papillary Fibroelastoma we talked about. Although this is not cancer, it is a condition that requires attention because it carries the risk of blood clots forming and traveling.
- Many people do not show symptoms, so medical tests are important.
- This is mainly diagnosed through an echocardiography test.
- Treatment is often surgery, which gives very good results.
- If you find out you have this condition , don't panic. Talk openly with your doctor, ask any questions you have, and get accurate information.
The most important thing is that you stay healthy!
` Papillary Fibroelastoma, heart disease, heart tumors, heart valves, stroke, heart attack, echocardiogram, heart surgery, benign tumor, heart health
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