Abstract
BACKGROUND: Primary cardiac angiosarcomas are extremely rare, highly aggressive tumors characterized by rapid progression and high metastatic capability. CASE SUMMARY: We present a case with unexplained pericardial hematoma after repeated right coronary infarction, combined with multimodality imaging and histopathologic examination, finally diagnosed as angiosarcoma. DISCUSSION: There is no published case of angiosarcoma onset of pericardial hematoma after repeated myocardial infarction. Multimodality imaging contributes to early diagnosis and optimal preoperative planning.