Ventricular tachycardia: beginning and ending fate of a benign invasive cardiac lipoma

  • Olga Vriz Heart Centre Department, King Faisal Specialist Hospital and Research Center; School of Medicine, Alfaisal University, Riyadh, Saudi Arabia. https://orcid.org/0000-0001-8212-8646
  • Mawada M. Ahmed | mawadamoh@hotmail.com Security Forces Hospital, Cardiology Department, Riyadh, Saudi Arabia. https://orcid.org/0000-0002-8499-7252
  • Suleiman Kharabsheha Heart Centre Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
  • Mohammed Aladmawi Heart Centre Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
  • Bandar Alamro Heart Centre Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. https://orcid.org/0000-0002-8767-0108
  • Afrah AlSomali School of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
  • Nader Fawzy School of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
  • Aly ALsanei Heart Centre Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
  • Najmeddine M. Echahidi Heart Centre Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.

Abstract

Cardiac lipomas are rare benign heart tumors. Their clinical manifestations primarily depend on their dimension and location. We describe a case of a 14-year-old boy complaining of palpitations. ECG showed non-sustained ventricular tachycardia (NSVT). Echocardiography and cardiac MRI showed a large apical mass suggestive of a cardiac lipoma. The patient underwent open-heart surgery which detected a pericardial mass, partially attached to the myocardium, and crossed by the distal segment of LAD. This critical anatomical relationship prevents its complete resection. The biopsy confirmed mature fat tissue. Postoperatively, Propranolol was started for NSVT episodes. After 8 months, he presented with VT recurrence. A subcutaneous ICD (S-ICD) was implanted. Two months later, he was admitted for an electrical storm with six appropriate shocks. Since then, amiodarone was added. Lipomas are not always benign and their surgery might be very difficult and unhelpful. A multidisciplinary team is crucial for their diagnosis and management.

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Published
2020-07-15
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Issue
Section
Cardiology - Case Reports
Keywords:
Ventricular tachycardia, cardiac tumor, lipoma, ablation
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  • PDF: 57
How to Cite
Vriz, O., Ahmed, M. M., Kharabsheha, S., Aladmawi, M., Alamro, B., AlSomali, A., Fawzy, N., ALsanei, A., & Echahidi, N. M. (2020). Ventricular tachycardia: beginning and ending fate of a benign invasive cardiac lipoma. Monaldi Archives for Chest Disease, 90(3). https://doi.org/10.4081/monaldi.2020.1288