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Primary cardiac tumors are rare. The majority of primary tumors of the heart are benign with papillary fibroelastomas being the third most common after myxomas and lipomas respectively. Papillary fibroelastomas represent the most common valvular tumor of the heart. Although benign, papillary fibroelastomas have the potential to cause turbulent flow, thrombus formation, and severe cerebral or coronary embolic disease. The majority of fibroelastomas have been described on the left side of the heart involving the aortic and mitral valves. We present a rare case of a papillary fibroelastoma occurring on the pulmonic valve.

Actinomyces israelii is a gram-positive bacillus that is rarely associated with infections in the general population. A. israelii belongs to the normal flora of the body and it rarely becomes pathogenic. Cardiac involvement is rare and in most cases involves the pericardium. Fewer than 20 cases of pericardial actinomycosis have been reported in the literature since 1950. We report the case of a 75-year-old man with a history of coronary artery disease with recent myocardial infarction and stent placement, atrial fibrillation, and recent colonic perforation with subsequent colectomy/colostomy who presented to our hospital with a 2-week history of left-sided chest pain. Workup revealed the presence of a pericardial effusion and pericarditis. Pericardial fluid analysis demonstrated A. israelii. An examination and discussion of the literature is performed regarding this rare manifestation of human actinomycosis.

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