Abstract
Primary cardiac tumours in infants are rare, mostly benign, but can cause life-threatening complications. We present a 2-month-old female with respiratory distress, poor feeding, and prior pericardial effusion/cardiac arrest. Transthoracic echocardiography revealed a right atrial mass with massive pericardial effusion. Hemodynamic instability prompted urgent surgery. Intraoperatively, the tumour infiltrated the right atrial anterior wall and atrioventricular groove; subtotal resection and atrial reconstruction using a bovine pericardial patch were performed. Histopathology confirmed benign capillary hemangioma (CD31/CD34 positive). The infant recovered well, remaining recurrence-free at one year. This case illustrates the severe potential of cardiac capillary hemangiomas in infants. Despite critical location and rapid progression, surgical debulking stabilized hemodynamics despite incomplete resection.