Unveiling Cardiac Mysteries: The Role of Endomyocardial Biopsy in Diagnosing Heart Masses (JACC Case Reports January 2025)-Article: Unveiling Cardiac Mysteries: The Role of Endomyocardial Biopsy in Diagnosing Heart Masses

Article: Unveiling Cardiac Mysteries: The Role of Endomyocardial Biopsy in Diagnosing Heart Masses

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The case series presented discusses the pivotal role of endomyocardial biopsy (EMB) in diagnosing cardiac tumors, emphasizing its utility over surgical resection. EMB provides crucial diagnostic data that influences therapeutic decisions, thereby avoiding unnecessary surgeries and aiding in effective management through a multidisciplinary approach. The series outlines cases where EMB was instrumental, such as a 75-year-old woman initially suspected of having angiosarcoma, later confirmed through EMB to have large B-cell lymphoma, and consequently treated with chemotherapy successfully. Similarly, in another case, a 64-year-old man with a complex oncologic background had a cardiac mass initially suspected to be metastatic renal cell carcinoma, but EMB revealed it to be a carcinoma of unknown primary, steering the treatment towards chemotherapy.<br /><br />EMB's diagnostic accuracy is highlighted as a significant advantage, especially in cases where conventional imaging fails to provide definitive conclusions. Its relatively low risk of major complications makes it a viable option in evaluating and managing cardiac masses. The report cites guidelines from prominent cardiology associations, recommending EMB use for diagnosing cardiac masses, and underscores the importance of careful application to maximize benefits while minimizing risks. These cases illustrate EMB's indispensability in cardiac tumor diagnostics, potentially improving patient outcomes by guiding appropriate interventions without resorting to more invasive surgical procedures. Despite its current efficacy, further research is encouraged to expand EMB's diagnostic capabilities and refine the procedure to further mitigate associated risks.

Keywords

endomyocardial biopsy

cardiac tumors

diagnostic accuracy

multidisciplinary approach

therapeutic decisions

cardiology guidelines

non-invasive procedure

patient outcomes

cardiac masses

diagnostic capabilities