Cardiac Lipoma of the Interventricular Septum

Cardiac lipomas are rare benign primary neoplasms of the heart, usually found incidentally, that can become symptomatic depending on their size and location. We report the case of a 61-year-old man presenting with chest pain and elevated troponin and a normal EKG and D-dimers. A transthoracic echocardiogram revealed an intracardiac mass attached to the interventricular septum protruding to the left ventricle, later confirmed to be a lipomatous mass consistent with a cardiac lipoma on cardiac magnetic resonance imaging. Due to the mass characteristics and favourable evolution, it was decided not to excise the tumour, and the patient remains asymptomatic after a 4-year follow-up period. LEARNING POINTS: Cardiac lipomas are rare benign tumours, usually found incidentally, although they can cause a wide array of symptoms depending on their size and location.Cardiac magnetic resonance imaging is the most accurate diagnostic method to characterize lipomatous cardiac masses and to distinguish lipomas from liposarcomas.Surgical excision is the mainstay of the treatment when feasible, although small asymptomatic lipomas can be managed with a vigilant non-invasive approach.