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.