Background
The incidence of primary cardiac tumours is less than 1%1, and Angiosarcoma is the most common malignant primary cardiac tumour in adults1. Angiosarcoma can present with signs of heart failure, constitutional symptoms such as weight loss and systemic embolic events2. Echocardiography is crucial for diagnosis of these tumours2,3.
Traditionally it has always been considered that transthoracic echocardiography (TTE) by a fully accredited practitioner is required to pick up rare cardiac tumours. Whilst it is true that a full TTE allows detailed characterisation of these tumours, the initial identification of an abnormal cardiac mass can be achieved with a basic focused echocardiography tool such as Focused Intensive Care Echo (FICE). The FICE training programme was designed by the Intensive Care Society in collaboration with the British Society of Echocardiography (BSE)4 and is designed to give real-time assessment of haemodynamics, cardiac function and filling. However, if FICE practitioners develop a high level of scanning ability other pathology can also be identified. Ultimately this means that FICE should be regarded as a non-invasive diagnostic tool which should be available to all critical care clinicians as it can influence patient management significantly.