Cardiac Hemangiomas: A Five-Year Systematic Review of Diagnosis, Treatment, and Outcomes

<b>Background/Objectives:</b> Cardiac hemangiomas are rare benign vascular tumors, accounting for less than 2% of primary cardiac tumors. Despite their rarity, they can cause significant clinical effects depending on their size and location. This systematic review aims to provide an updated analysis of recent cases, focusing on epidemiology, histopathological subtypes, clinical presentation, diagnostic approaches, and treatment outcomes. <b>Methods:</b> A systematic search of the PubMed database identified case reports and series published between 2019 and 2025. After applying inclusion and exclusion criteria, 55 eligible cases were selected for analysis. Data were extracted on patient demographics, tumor characteristics, imaging methods, treatment strategies, and follow-up outcomes. <b>Results:</b> Cavernous hemangiomas were the most commonly reported subtype. Patient ages ranged from infancy to over 85 years, with a slight predominance in females. Presentations varied from asymptomatic incidental findings to symptoms such as dyspnea and chest pain. Echocardiography was the primary diagnostic tool in over 80% of cases. Surgical resection was performed in 87.3% of patients, yielding favorable outcomes and low recurrence. However, follow-up duration was inconsistent, and long-term outcomes were underreported, underscoring the lack of standardized surveillance protocols. This variability limits clinicians' ability to assess recurrence risk and long-term prognosis, highlighting the need for evidence-based guidelines to inform structured follow-up and improve patient care. <b>Conclusions:</b> The increasing number of published cases likely reflects improved diagnostic imaging and greater clinical awareness. While surgery remains the preferred treatment, the variability in follow-up and diagnostic reporting highlights the need for standardized protocols. Further studies are warranted to clarify the natural history, refine classification systems, and establish evidence-based guidelines for the management of this rare cardiac tumor.