The clinical manifestations of cardiac lipoma depend on the location of the tumor, and may vary from valvular dysfunction to obstruction of a cardiac chamber, impeding the filling and emptying processes . Symptoms may include heart failure, arrhythmia and syncope. Tumors of the right atrium, interatrial septum, and right ventricle can predispose to arrhythmias . Türkoglu H and his colleagues  reported a case of a 24-year-old woman who presented with palpitations and was found to have a lipoma attached to the left side of the IVS. Our patient felt chest congestion and shortness of breath after physical activity for a long time and worsening dyspnea and increasing fatigue whose lipoma located in the upper portion of IVS projecting into the right ventricular outflow tract. The increasing size of the tumor caused underfilling of the right ventricle with rapid deterioration of symptoms. The location and size of the tumor may contribute to the patient’s symptoms. The cardiac lipoma can be diagnosed by echocardiogram, CT and MRI. Echocardiogram is useful to diagnose both benign and malignant tumors. The use of CT scan and MRI are facilitated to the diagnosis of the lipomas and exactly predict the intramyocardial extent and the relationship to other cardiac structures . MRI is particularly useful because it allows the characterization of the tissue . In our case, a mass in the heart was initially detected with transthoracic echocardiogram. CT scan and MRI were further applied to characterize the mass. Post operative pathology confirmed the pre-operative diagnosis of lipoma. So we think that echocardiogram, CT and MRI are necessary to the diagnosis of the cardiac tumor.
Because of potential lethality, theoretically, all cardiac tumors should be indicated for surgery, independing from symptomatology. If there are no contraindications, surgical resection is the treatment of choice for all patients with cardiac neoplasms. The approaches to resect the tumor depends on tumor sizes and locations. In this case, the patient was symptomatic and deteriorated progressively. We recommended surgical treatment and advise this patient to reexamination twice a year after successful treatment.