Cardiac tumors are relatively rare, with primary hemangiomas being a particularly rare benign neoplasm. Herein, we report a case of a symptomatic cardiac tumor detected via echocardiography in an 82-year-old woman. Although we performed advanced imaging examinations for her heart, we could not diagnose the tumor before surgery. Eventually, a tumor involving the left atrial roof was detected, and it was completely resected to relieve her symptoms and establish a precise diagnosis. Histopathological examination indicated a cardiac cavernous hemangioma. The patient exhibited an uneventful recovery without any complications.

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A 79-year-old man with chest pain and dyspnea underwent emergency percutaneous coronary intervention for acute myocardial infarction. However, he died 17 days later due to refractory heart failure. An autopsy revealed cardiac strangulation caused by herniation of the apical heart through a pericardial defect due to partial absence of the pericardium. ( Level of Difficulty: Advanced. )

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