PP-233 New Methods For Evaluation Of Cardiac Mass: 2D Speckle Tracking, 3D Volumetric Quantification

New Methods For Evaluation Of Cardiac Mass: 2D Speckle Tracking, 3D Volumetric Quantification. F. Helvaci, F.S. Biricik, M.C. Sumerkan, T. Hamit, A. Gurdal, Ş. Cetin. Department of Cardiology, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey; Department of Oncology, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey. Introduction: Cardiac tumors are very rare. The clinical presentation can range from cardiac arrhythmias, heart failure, left or right ventricular outflow tract obstruction to sudden death. Despite some publications showed metastatic cardiac tumors, very few of them caused by hypopharyngeal carcinoma. Herein, we present a case of a patient who has hypopharyngeal squamous cell cancer with cardiac metastasis, which is incidentally detected by echocardiography Case Details: A 24-year-old female has been following for hypopharyngeal squamous cell cancer. She was treated by concomitant radiotherapy and cisplatin. In routine evaluation, there had been a progression in the metastatic lesions which are in lungs and neck.Cisplatinþ5FUþcetuximab therapy has been started. In routine cardiac evaluation, negative T wave in inferior leads had been detected on ECG. She had been referred to the cardiology clinic. She had no cardiovascular history. Physical examination, blood biochemistry values (excluding anemia) and cardiac markers were in normal range. Her blood pressure was 120/80 mmHg on admission. Electrocardiography showed us sinus tachycardia with negative T waves in DII-DIII, aVF leads, rate was 100beats/min (Figure 1A). Transthoracic echocardiography showed; normal systolic function and asymmetric septal wall hypertrophy.. A subsequent X-Plane imaging showed an ovoid shaped mass lying through inferior septal walls and some part of the right ventricle (Figure 1B). 3-Dimensional echocardiography was performed for further evaluation. 3D-echocardiography demonstrated suspected hypertrophy on the inferior septal wall without pericardial effusion. Also we have had a 3-D full volume image and they showed us that all segments of the left ventricle, including the parts which involve the mass, had no wall motion abnormality (Figure 1C). After we performed 2-D speckle tracking evaluation we examined circumferential strain dyssynchrony in the inferoseptal wall which has been infiltrated by tumor (Figure 1D, E). After MR Imaging, it was clear that the nature of the masswasmetastatic (Figure 1F). In our case, in admission themasswas not associated with complications, the patient was asymptomatic and mass growth was not very important. Hereby conservative approach adopted, with a close surveillance. The American Journal of Cardiology MARCH 13e16, 2014 10 IN AND C Conclusion: Identification of intracardiac masses with imaging modalities is important. If this kind of mass was bypassed, it may lead to serious health problems or mortality. Due to the uncommon nature of cardiac metastasis, unusual located intracardiac masses should be kept in mind inpatients with malignancy. In this way X-plane, speckle tracking and 3-D echocardiographic evaluation provide new highlights for examination of intracardiac masses. Congenital Heart Diseases: Vascular and Structural Abnormalities (Abstract nos. PP-234 w PP-258, PP-369 w PP-372)