Cardiac Tumors Causing Sudden Cardiac Death: A State-of-the-Art Review in Pathology

Cardiac tumors (CTs), although rare, can be a significant cause of sudden cardiac death (SCD), particularly when not diagnosed early. The tumors most associated with SCD include myxomas, fibromas, rhabdomyomas, and sarcomas, which can cause fatal arrhythmias, blood flow obstruction, or embolization. Myxomas, which often develop in the left atrium, can cause valvular obstruction or cerebral emboli, while malignant tumors, such as sarcomas, can infiltrate the myocardium or conduction system, causing serious arrhythmias. Rhabdomyomas, which are common in children and associated with tuberous sclerosis, can lead to ventricular tachyarrhythmias. Early diagnosis using advanced imaging techniques such as echocardiography and magnetic resonance imaging is crucial for preventing SCD. Timely diagnosis and precise characterization of lesions can help reduce the risk of SCD, thus improving the clinical management of patients, with the aim of supporting personalized treatment and improving life prospects. In this state-of-the-art review, we analyze the association between CTs and SCD, with particular attention to the histological features of benign and malignant neoplasms. Through an updated overview of the pathological aspects, we aim to improve the understanding of these tumors and promote a more effective multidisciplinary diagnostic and therapeutic approach to prevent fatal events.